Why elevated urine potassium levels in burn patients...

[jdallnurse]

Hi! Any input is appreciated.......Student trying to enhance critical thinking skills:banghead:

1) Why would burn patients have elevated urine potassium levels? Is it d/t the potassium leaving the ICF d/t tissue destrution and entering bloodstream which is excreted in the urine?

2) Dehydrated pt. erroneously receives hypertonic glucose sol. instead of NS, how would this affect plasma ADH and urine vol.? Will it raise ADH and increase urine vol?

[Babs0512]

1. Correct

2. Correct - but the patient will still have an increase in urine output as the body cells lose fluid in the attempt to "dilute" the intravascular fluid (Blood).

[iluvivt, BSN, RN]

You got it. Since K+ is mostly an intracellular ion in burn or crushing injuries and other electrolte imbalances and in acidosis it will move from the ICF to the ECF. your thinking on question two is also correct. Keep in mind that Normal saline is isotonic with 154 meq of NA and 154 meq of CL-. It is generally not used for hydration bc over time (in as little as 24 hrs) the patients Na+ level will increase. Isotonic fluids stay in the ECF and hypotonic are hydrating (ie D5 1/2 NS,D5 1/4 NS and D5W). They enter the cells to rehydrate. A hypertonic fluid will pull fluid into the ECF. Glucose is a large molecule and in the plasma will increase the urine output.

[jdallnurse]

Ok, now I see. I was stuck on how the glucose would affect it.....Thanks

[jdallnurse]

Thanks!! Just wanted to make sure I was on the right track.