Monday, December 23, 2013

CLINICAL TIP FOR NURSES: WHO WINS? GLUCOSE OR INSULIN?


student nurse, new nurse, graduate nurse, renee thompson, rtconnections
Is it the glucose or the insulin??


When I teach clinical seminars, I always, always talk about fluid and electrolytes. One of my favorite things to talk about is potassium. In particular, how we treat hypo and hyperkalemia. In the next few blog posts, I'm going to map out some of the most common treatments for hyperkalemia - starting with glucose and insulin.
One thing you need to understand about potassium is that you have WAY MORE potassium INSIDE (145 mEq/L) the cell than you do OUTSIDE (3.5-5 mEq/L) the cell. So, any time you damage the cell wall or change the pH of the blood (will discuss that in a future blog post), the potassium INSIDE the cell will leak out into the extracellular space (blood vessel). 
Knowing that hyperkalemia can wreak havoc on the heart and other muscles, it's important to get the potassium back into the cell where it belongs!!!