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A worrisome outcome of hyperkalemia is cardiac dysfunction. On EKG, hyperkalemia first manifests as peaked T waves, and can lead to ventricular fibrillation, which can be fatal. Cardiac complications can be prevented with the administration of calcium (usually administered as calcium gluconate), which stabilizes the cardiac membrane. Mnemonic: imagine a peaked T wave as being peaked because it is a mountain of K.
Sayfa 63 - Calcium gluconate is also used in magnesium toxicity.
What happens when one vomits?
One loses lots of acid from the stomach. If vomiting causes acid loss, an alkalosis will remain behind in the serum. This is because H loss leaves behind an excess HCO3 eventually makes it to the kidneys, and thus the tubule lumen has more negatively charged ions than usual. One way of compensating for that is secreting the positive ion K into the lumen. So vomiting can lead to increased loss of K in the urine, resulting in hypokalemia.
Sayfa 64
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