[nclex]칼륨

Potssium(K+)
거의 세포에 존재, 소화액에 많이 존재한다. IV push, IM, SC로는 replace하지 않는다. 항상 diluted(희석)해서 사용하고 infusion device를 사용한다.
Normal value		3.5 to 5.0 mEq/L(3.5 to 5.0 mmol/L)
★ common food source		아보카도, 바나나, 오렌지, 딸기, 토마토, 당근, 버섯, 시금치, 생선, 돼지고기 소고기, 송아지 고기(veal), honeydew, 감자(익힌감자가 더 k+농도 높음) 건포도(raisins),cantaloup
function		1. nerve contraction 2. muscle contraction 3. cardiac contraction

	Hypokalemia	Hyperkalemia
심혈관계	irregular pulse weak peripheral pulses	slow, weak, irregular heart rate
신경근육	skeletal muscle weakness leg cramps	초기 : muscle twitches, cramps 후기 : profound weakness
위장관	decreased motility nausea, vomiting, constipation	increased motility, diarrhea heperactive bowel sounds anorexia,nausea, vomiting
★★EKG	ST depression;shallow, flat or inverted T wave; and prominent U wave	tall peaked T waves, flat P waves, widened QRS complexes, and prolonged PR intervals
cause	1. Excessive use of medication like as diuretics or corticosteroids 2. Increased secretion of aldosterone, like as in Cushing syndrome 3. vomiting, diarrhea 4. prolonged nasogastric suction	1. potassium-retaining diuretics ex)알닥톤 2.Adrenal insufficiency, such as in Addison's disease 3. movement of k+ from the intracellular fluid to the extracellular fluid -damage tissue(ex.crush injury) -acidosis -hyperuricemia -hypercatabolism
중재	place the client on a cardiac monitor.	1, kayexalate enema - fecal impaction(분변매복확인하지 않으면 대변이 약을 흡수하고 대변이 나오지 않으면 장벽이 괴사된다) - hold 30-45 mins with balloon cath - dont' mix with sorbitol(장벽괴사가능성↑) 2. Prepare for the IV administration of hypertonic glucose with regular insulin to move excess k+ into the cells. 3. instruct client to avoid the use of salt substitutes(심장질환자는 ok, 신질환자는 금기) or other potassium-containing substance.