By C. Baldar. University of Texas Southwestern Medical Center. 2018.
Nonetheless 75 mg plavix overnight delivery blood pressure fluctuation causes, it has been demonstrated that fewer action potentials — a weaker stimulus plavix 75 mg cheap hypertension 140 80, as it were — causes fewer motor units to become involved in a contraction. So it’s true that a muscle organ can have varying degrees of contrac- tion depending on the level of stimulation. As for how this can be so, one theory pro- poses that individual fibers have specific thresholds of excitation; thus, those with higher thresholds only respond to stronger stimuli. The other theory holds that the deeper a fiber is buried in the muscle, the less accessible it is to incoming stimuli. Complete fatigue occurs when no more twitches can be elicited, even with increasing intensity of stimulation. The short lapse of time between the application of a stimulus and the beginning of muscular response is called the latent period. Two types of muscle contraction relate to tone: Isometric: Occurs when a contracting muscle is unable to move a load (or heft a piece of luggage or push a building to one side). Isotonic: Occurs when the resistance offered by the load (or the gardening hoe or the cold can of soda) is less than the tension developed, thus shortening the muscle and resulting in mechanical work. Each muscle depends upon compan- ions in a muscle group to assist in executing a particular movement. Prime movers: Just as it sounds, these muscles are the workhorses that produce movement. Fixators or fixation muscles: These muscles serve to steady a part while other muscles execute movement. Synergists: These muscles control movement of the proximal joints so that the prime movers can bring about movements of distal joints. Which of the following statements finishes this sentence and makes it not true: A contracting muscle unable to move a load a. Isotonic motion Leveraging Muscular Power Skeletal muscle power is nothing without lever action. The bone acts as a rigid bar, the joint is the fulcrum, and the muscle applies the force. Levers are divided into the weight arm, the area between the fulcrum and the weight; and the power arm, the area between the fulcrum and the force. When the power arm is longer than the weight arm, less force is required to lift the weight, but range, or distance, and speed are sac- rificed. When the weight arm is longer, the range of action and speed increase, but power is sacrificed. Therefore, 90 degrees is the optimum angle for a muscle to attach to a bone and apply the greatest force. Three classes of levers are at work in the body: Class I, or seesaw: The fulcrum is located between the weight and the force being applied. An example is a nod of the head: The head-neck joint is the ful- crum, the head is the weight, and the muscles in the back of the neck apply the force. An example is standing on your tiptoes: The fulcrum is the joint between the toes and the foot, the weight is the body, and the muscles in the back of the leg at the heel bone apply the force. An example is flexing your arm and showing off your biceps: The elbow joint is the fulcrum, the weight is the lower arm and hand, and the biceps insertion on the lower arm applies the force. Here are the possible directions: Longitudinal: Fibers run parallel to each other, or longitudinally, the length of the muscle. Pennate: Fibers attach to the sides of the tendon, which extends the length of the muscle. These come in subcategories: • Unipennate, where fibers attach to one side of the tendon; example: tibialis posterior • Bipennate, where fibers attach to two sides of the tendon; example: rectus femoris • Multipennate, where fibers attach to many sides of the tendon; example: deltoideus Radiate: Fibers converge from a broad area into a common point. The three types of fasciae, which Gray’s Anatomy describes as “dissectable, fibrous connective tissues of the body,” are as follows: Superficial fasciae: Found under the skin and consisting of two layers: an outer layer called the panniculus adiposus containing fat; and an inner layer made up of a thin, membranous, and highly elastic layer. Between the two layers are the superficial arteries, veins, nerves, and mammary glands. Deep fasciae: Holds muscles or structures together or separates them into groups that function in unison.
Forensic anthro- pologists will recognize several categories of efects stemming from natural and anthropogenic causes discount 75 mg plavix hypertension hypokalemia. As bones disarticulate plavix 75mg generic how quickly do blood pressure medication work, they may be scattered by water or wind, depending on the slope of the terrain and the amount of water running across it. Fluvial transport ofen results in damage to ribs and the delicate structures of the skull base, depending on water velocity and distance traveled. As bones dry, some of Forensic anthropology 155 the fat elements of the skeleton may warp and crack, producing damage that might be confused with injury. Similarly, buried remains subject to many cycles of wetting and drying may display breakage of ribs, spinous processes, and other efects. Te weight of soil above a collapsed cofn may produce damage to the rib cage or pseudotrauma in the anterior dentition or deli- cate bones of the maxillofacial area. Large and small mammalian scavengers leave characteristic dental markings, usually perpendicular to the long axis of a bone. When recover- ing scattered remains, it is wise to ask what kinds of animals inhabit the area. Some familiarity with the dentition and the characteristic patterns of scavenging of animals within the area of search is useful. One colleague wryly noted that “if one wants to fnd remains in a large feld, one has only to instruct someone to ‘brush hog’ or till the area. Te most problematic instances of anthropogenic damage are those that produce recovery and processing artifacts. Shovels and trowels in the hands of inexperienced investigators may induce what appear to be blade or chopping defects. Cases involving remains that have been intentionally disarticulated by knife, saw, etc. On these occasions the initial examiner must carefully note and describe any additional cuts that have been made with the autopsy saw for sampling or other purposes, lest these be confused with original marks made by the assailant. Although most anthropogenic arti- facts are easily distinguished from perimortem damage, they ofen provide a skillful cross-examiner with opportunities to confuse a jury, and at the very least, may call into question the skills of those responsible for the recovery and analysis of the victim. Many states operate databases and missing persons clearinghouses for their own jurisdictions. Still other databases specialize in a particular demographic segment of the national population, e. Te latter contains reference samples consist- ing of nuclear and mitochondrial markers from relatives of missing persons as well as mitochondrial and, usually, genomic markers from unidentifed human remains. Or, the system may fnd several possible matches either for the same reason or because the original reference samples were taken from individuals who were not frst-degree relatives of the decedent. Given several possible matches, or one weak one, the anthropological and dental profles are used to parse the list or to strengthen the weak match. Most do not interact with others because of incompatible formats, propri- etary issues, or matters of confdentiality and access between jurisdictions and entities operating the various databases. Te most important limita- tion on the use of any database in identifying unknowns, live or dead, is its inclusiveness. Te best chance a missing individual or set of remains has of being identifed resides in whether these have been submitted to a database with as much accompanying information as possible. A signifcant problem arises because of the difering skill levels of those who initially develop the profle. If the unknown remains are sufciently complete and “fresh” to allow accu- rate determination of sex, age, ancestry, and stature visually, then a report from a pathologist may be sufcient for use as critical metadata. Errors in the assignment of ancestry or age, improper dental charting, or other misinformation entered into a database will likely result in false elimi- nation of a correct identity match, i. Although it is not always possible to accu- rately determine all of the features of the profle, an efort must be made. Many countries require that some form of personal identifer be entered into a national database; e. Tus, their value in large-scale searches for the missing and unknown remains is negligible. Te promise of databases will not be realized until the problems of accurate data entry and interconnec- tivity as well as broad public acceptance and participation are resolved. Increased use of anthropological fndings as metadata within a molecular and biometric database identifcation framework will mandate more comprehensive validation studies to strengthen ele- ments of the biological profle in a post-Daubert environment.
Athletes buy 75mg plavix otc heart attack nitroglycerin, musicians purchase plavix 75mg overnight delivery heart attack enzyme, and other performers use a tion, regression, fixation, identification, introjection, ra- form of daydreaming known as visualization. As the in- tionalization, isolation, sublimation, compensation, and dividual prepares for a competition or performance, he humor. Denial and repression both distort reality by or she forms a mental picture of him- or herself execut- keeping things hidden from consciousness. In very young children, sion is considered one of the more mature and healthy a degree of denial is normal. For example, a the undesirable feelings are attributed to another person child who is told that her parents are divorcing may deny or persons. An angry person believes others are angry at that it is happening or deny that she is upset about it. De- her; a person who is critical of others believes they are nial has been shown to be effective in reducing the critical of him. Very young children are especially prone arousal caused by a threatening situation. In life-threat- to projection because of their egocentric orientation, ening or other extreme situations, denial can temporarily which blurs the boundary between themselves and oth- be useful in helping people cope, but in the long term ers, making it easier to also blur the distinction between painful feelings and events must be acknowledged in their feelings and those of others. Related to denial is avoidance, which involves Displacement is a defense by which an impulse per- avoiding situations that are expected to elicit unwanted ceived as dangerous is displaced, either through redirec- emotions and impulses. In the first type, known as object displacement, In repression, painful feelings are conscious initially anger or another emotion is initially felt toward a per- and then forgotten. However, they are stored in the un- son against whom it is unsafe to express it (in children, conscious,from which, under certain circumstances, for example, toward a parent). Displacement functions as they can be retrieved (a phenomenon Freud called “the a means by which the impulse can still be expressed—al- return of the repressed”). Repression can range from mo- lowing a catharsis of the original emotion—but toward mentary memory lapses to forgetting the details of a cat- a safer target, such as a sibling, peer, or even a toy. Other situations may also occasion the repres- parent who is repressing feelings of resentment or rejec- sion of hostile feelings toward a loved one (especially a tion toward a child may overcompensate by appearing to parent). Possibly the most extreme is child abuse, the be lavishly generous and solicitous of the child’s wel- memory of which may remain repressed long into adult- fare. In this type of situation, the child generally senses hood, sometimes being deliberately retrieved in therapy the true hostility underlying the parent’s behavior. The Freudian stage of sexual laten- pression, is suppression, by which unpleasant feelings cy in middle childhood is yet another example of reac- are suppressed through a conscious decision not to think tion formation: in order to repress their sexual feelings, about them. Suppression differs from repression and de- children at this age evince a strong sense of indifference nial in that the undesirable feelings are available but de- or even hostility toward the opposite sex. Sometimes a liberately ignored (unlike repression and denial, where distinction is drawn between feelings that are diametri- the person is completely unaware of these feelings). Sup- cally opposed to a repressed impulse and the actual be- pression generally works by replacing unpleasant havior that expresses them, with the former called reac- thoughts with others that do not produce stress. Cognitive behavior therapy in par- Two defense mechanisms—regression and fixation ticular makes use of this technique to help people com- —are associated with developmental disturbances in bat negative thought patterns that produce maladaptive children. In this way, inappropriate sexual or aggressive gained developmental ground but refuses to move ahead impulses can be released in sports, creative pursuits, or because developmental progress has come to be associat- other activities. Other defense Identification, which is basic to human development mechanisms generally viewed in a positive light include and an essential part of the learning process, can also compensation —devoting unusual efforts to achievement serve as a defense mechanism. Taking on the characteris- in order to overcome feelings of inferiority—and the use tics of someone else can enable a person to engage in of humor as a coping device. Further Reading Another motive for identification is a fear of losing the Firestone, Robert W. New York: Human Sciences Press, known variety of identification is identification with the 1989. New way takes on the traits of the victimizer to combat feel- York: International Universities Press, 1966. Vital Lies, Simple Truths: The Psychology of may occur in response to aggression that is imagined Self-Deception.
Nurses should consider the effects of their activities on intracranial pressure; Rising (1993) and Price (1998) give useful overviews of potential problems plavix 75mg low price heart attack now love. At a party following a successful rugby game cheap plavix 75 mg with visa heart attack lyrics sum 41, Mark fell out of a second-floor window and sustained a head injury with fractured right elbow and pelvis. Mark’s fractures were stabilised and intracranial pressure monitoring was initiated. He was invasively ventilated, sedated with midazolam and fentanyl infusions with pancuronium administered to promote muscle relaxation. What is the likely cause and significance of his temperature and blood sugar results? Since most pathophysiological processes originate at cellular level, Chapter 23 gives an overview of cellular pathology. Multiple, often interacting, pathology creates complex links between the pathologies and treatments discussed in this section, but chapters are then grouped largely by systems and treatments, starting with those more obviously related to cellular pathology: myocardial infarction, shock, multiorgan dysfunction syndrome and acute respiratory distress syndrome. These chapters do include some discussion of treatments, but further treatments are discussed in the next group of chapters: nitric oxide, alternative modes of ventilation and cardiac surgery. Two frequent complications of critical illness are discussed next: disseminated intravascular coagulation and acute renal failure. Further treatments are then discussed: fluid management, (positive) inotropes and haemofiltration. Issues surrounding transplantation (donors and recipients) are discussed in Chapter 43; care of patients following graft surgery is covered in the chapter on hepatic transplants. The complex interaction between systems necessitates holistic care, and so cross- references are given to other chapters; the reductionist presentation of each chapter is Pathophysiology and treatments 233 designed to assist easy reference by readers wishing to find out more about each pathophysiological process. Chapter 23 Cellular pathology Introduction Focus on visible macrophysiology (systems and organs) has increasingly been replaced by recognition that disease processes originate primarily at microphysiological levels; organ/system failure is more a symptom of widespread cell failure. This chapter therefore outlines pathological mechanisms underlying most critical illnesses; hence its placement before discussion on more familiar macrodisease processes. Recent growth in the understanding of microphysiological and microbiological processes necessitates selection of key aspects. Much remains to be discovered, clarified or proven; knowledge growth can rapidly outdate material covered in even relatively recent courses and texts. This chapter therefore begins with a brief revision of cell physiology; if unfamiliar, this should be supplemented from anatomy texts. The importance of cellular pathology in most diseases is reflected in the many references to this chapter in later ones; readers may find sections in this chapter useful as reference points for later use. The movement of electrolytes across the membrane creates the action potential (see Chapter 21) needed for muscle movement: potassium leak during the resting phase of action potential creates a negative intracellular charge (−20 to −200 millivolts), causing influx of positively charged ions. Sugar (for cellular energy production) influx is facilitated by insulin, hence hyperglycaemia, but lack of energy when insulin production or function is impaired. Cell membranes, therefore, maintain intracellular homeostasis; damage to the cell membrane disrupts cell function, with extensive damage resulting in organ dysfunction. However, with anaerobic metabolism most intracellular pyruvic acid is converted to lactic acid, which then diffuses out of cells creating metabolic acidosis. Thus metabolism during hypoperfusion (shock, pressure sores) is inefficient, causing accumulation of toxic waste (acids and carbon dioxide) which enter capillary circulation causing metabolic acidosis. Cell damage Nowak and Handford (1996) identify three mechanisms for cell damage: ■ deficiency (e. Hypoxic cells (especially endothelial) release various cytotoxic and vasoactive mediators (histamine, serotonin, kinins). Progressive equilibrium between intracellular and extracellular ions impairs action potential generation. The accumulation of intracellular fatty deposits accelerates cell damage and rupture, with the kidneys, heart and liver being especially susceptible (e. Tissue tolerance to hypoxia varies; central nervous system neurons have high metabolic rates, relying on glucose for energy and can only tolerate a few minutes of ischaemia (hence cardiopulmonary resuscitation times); renal and hepatic cells can tolerate an hour’s ischaemia at normal body temperature (enabling safe isolation for most surgical procedures); hypothermia reduces metabolic rate, and so extends ischaemic toleration time (hence use of hypothermia for cardiac surgery). Cellular pathology 237 Microcirculation Most critical pathologies are fuelled by hypoperfusion from microcirculatory collapse (see Chapter 25). Vasoactive mediators (part of normal homeostasis) relax smooth muscle in arterioles, but venules remain constricted; the resulting pressure gradient forces plasma into interstitial spaces (oedema). Resulting haemoconcentration increases blood viscosity, which further reduces perfusion (see Chapter 18) and encourages thrombi formation.
Interestingly quality plavix 75mg blood pressure 34 year old male, it’s not just right-side/left-side controls that are reversed in the cerebrum; the upper areas of the cerebral cortex control the lower body activities while the lower areas of the cortex control upper-body activities in a reversal called “little man upside down purchase 75 mg plavix amex blood pressure 5040. The corpus callosum Chapter 15: Feeling Jumpy: The Nervous System 247 physically unites the two hemispheres and is the largest and densest mass of commis- sural fibers. Different functional areas of the cerebral cortex are divided into lobes: Frontal lobe: The seat of intelligence, memory, and idea association Parietal lobe: Functions in the sensations of temperature, touch, and sense of position and movement as well as the perception of size, shape, and weight Temporal lobe: Is responsible for perception and correlation of acoustical stimuli Occipital lobe: Handles visual perception Medulla The medulla, the region interior to the cortex, is composed of white matter that con- sists of three groups of fibers. Projection fibers carry impulses afferently from the brain stem to the cortex and efferently from the cortex to the lower parts of the central nerv- ous system. Association fibers originate in the cortical cells and carry impulses to the other areas of the cortex on the same hemisphere. Ventricles The brain’s four ventricles are cavities and canals filled with cerebrospinal fluid. The lateral ventricles com- municate with the third ventricle through the foramen of Monro. The third ventricle is connected by the cerebral aqueduct to the fourth ventricle, which is continuous with the central canal of the spinal cord and contains openings to the meninges. The fourth ventricle has openings that allow fluid to enter into the subarachnoid spaces. Lining the ventricles is a thin layer of epithelial cells known as ependyma, or the ependymal layer. Along with a network of capillaries from the pia mater, the ependyma and capillaries form the choroid plexus, which is the source of cerebrospinal fluid. The choroid plexus of each lateral ventricle produces the greatest amount of fluid. Fluid formed by the choroid plexus filters out by osmosis (refer to Chapter 2) and circulates through the ventricles. Fluid is returned to the blood through the arachnoid villi, finger-like projections of the arachnoid meninx, which absorbs the fluid. Twelve pairs of cranial nerves connect to the central nervous system via the brain (as opposed to the 31 pairs that connect via the spinal cord). Check out Table 15-1 for a listing of all the nerves, and then read on for a memory tool. That’s a mouthful, but students have come up with a number of memory tools to remember them. Our favorite is: Old Opera Organs Trill Terrific Arias For Various Grand Victories About History. Unmyelinated fibers, cell bodies, and neuroglia Part V: Mission Control: All Systems Go 250 44. The part of the brain that contains the thalamus, pituitary gland, and the optic chiasm is the a. Use the terms that follow to identify the parts of the brain shown in Figure 15-3. Fourth ventricle Chapter 15: Feeling Jumpy: The Nervous System 251 51 _____ 62 _____ 52 _____ 53 _____ 54 _____ 55 _____ 61 _____ 56 _____ 57 _____ 60 _____ Figure 15-3: Sagittal 59 _____ 58 _____ view of the brain. Wolters Kluwer Health — Lippincott Williams &Wilkins Taking Side Streets: The Peripheral Nervous System The peripheral nervous system is the network that carries information to and from the spinal cord. Among its key structures are 31 pairs of spinal nerves (see Figure 15-4), each originating in a segment of the spinal cord called a neuromere. Eight of the spinal nerve pairs are cervical (having to do with the neck), 12 are thoracic (relating to the chest, or thorax), five are lumbar (between the lowest ribs and the pelvis), five are sacral (the posterior section of the pelvis), and one is coccygeal (relating to the tail- bone). Spinal nerves connect with the spinal cord by two bundles of nerve fibers, or roots. The dorsal root contains afferent fibers that carry sensory information from receptors to the central nervous system. The cell bodies of these sensory neurons lie outside the spinal cord in a bulging area called the dorsal root ganglion (refer to the cross-section of the spinal cord in Figure 15-2).
With the arrival of western medicine generic plavix 75 mg visa heart attack or gas, acupuncture was increasingly relegated to rural and remote back- waters discount plavix 75mg heart attack jack black widow. Acupuncture developed once again as people were quickly trained and pressed into service. News of the success of acupuncture was brought to the west in 1683 by Dr Willen Ten Rhijn, a physician working for the Dutch East Indies Company in Japan. Acupuncture was widely practised in France in the late eighteenth century with Dr Berlioz, a Parisian doctor, becoming the first western prac- titioner of acupuncture in the early nineteenth century. John Churchill, the first British acupuncturist, used the technique in the treatment of rheuma- tism in 1821. Acupuncture was even mentioned in the first edition of The Lancet in 1823 as being chiefly used in ‘diseases of the head and lower belly’. In Scotland, a random survey found that an impressive 94% of respondents in a random survey knew something about acupuncture and 25% said that they would consider using it, although in practice only about 6% had actually done so. Principles of acupuncture In addition to the classic principles of Chinese medicine outlined above, there is one key aspect of practice still to consider. This is the theory of acupuncture points that are stimulated usually by the superficial insertion of 136 | Traditional medicine needles into the skin. Other methods of stimulation include the application of pressure and the passing of a weak electrical current (see below). A further 1000 extra points and special use points may also be identi- fied on the hands, ears and scalp. It is not known how these points were discov- ered – probably it was by observation over hundreds if not thousands of years – nor is it known exactly how many points were first identified. Acupoints cannot be identified by their appearance and no consistent features of their anatomy have been found that distinguish them from other tissues. Practice of acupuncture There is archaeological evidence that shows that the earliest acupuncture needles date back to the Stone Age, when instruments called bian were thought to have been used in China. Needles were subsequently made of many different metals: gold, silver, copper, etc. Modern acupuncturists use solid sterile disposable needles of narrow bore, about 3 cm long (although longer needles may be used at different sites). As many as 15–20 needles may be inserted superficially at the appro- priate point(s). The practitioner then gently introduces the needles a little more deeply into the muscle, rotating them between finger and thumb. Qi and blood flow throughout the meridians and this is where manipulation of the needle is critical in properly moving this flow. The arrival of qi called deqi is signified by a dull ache or tingling sensation and slight inflammation. Some practitioners may use electrical stimulation, connecting the needles to a small piece of equipment powered by batteries. Needles are left in place for up to 20 min: the patient is invited to lie back and relax. Occasionally a needle may be left in place for several days, normally situated in the ear; these so-called indwelling needles should not be used in patients with heart valve disease or who are immunocompromised. Acupuncture point selection may vary at each treatment, depending on the patient’s response. Positive trials have been criticised because of inadequate blinding, and negative trials because the intervention was not administered by properly trained practitioners or control interventions may have had analgesic effects. The panel said that acupuncture was ‘probably’ also effective in the control of nausea in early pregnancy. The British Medical Association reached a similar conclusion in their report on acupuncture. Even if they can, there is evidence that acupuncture at non-classic points, the so-called trigger points, may have analgesic effects. When the needle was ‘inserted into the skin’ participants saw and felt the needle penetration. Both sham and genuine needles were held in place with a plastic ring and surgical tape so the procedure looked identical.
Plasmanate is non-antigenic and must not be given to patients who have anemia cheap plavix 75 mg with amex blood pressure chart for dogs, increased blood volume plavix 75 mg with amex hypertension jnc, or congestive heart failure. Blood and Blood Products Blood and blood products consist of whole blood, packed red blood cells, plasma, and albumin. Whole blood should be used to treat severe cases of anemia—not mild cases of anemia—because one unit of whole blood elevates hemoglobin by 0. Fluid Replacement The amount of water a patient requires each day depends on the patient’s age and the nature of the patient’s medical condition. Each day the patient losses: • 400 mL to 500 mL of water through evaporation from the skin. This means that each day the patient must take in between 1900 mL and 2400 mL of fluid in order to maintain fluid-electrolyte balance. However, dis- ease and the treatment of disease can increase the patient’s output of water requiring that the patient increase the intake of water. For example, a patient who has a fever loses as much as 15% more water than the normal daily water loss. That is, the patient loses between 2185 mL and 2760 mL of water each day when he or she has a fever. Potential nursing diagnoses for a patient that is receiving fluid volume replacement therapy are: • Risk for fluid volume excess. This can occur when the patient is given too much replacement fluid, fluid is infused too rapidly, or the volume is too much for the patient’s physical size or condition. The patient should be taught: • To recognize signs and symptoms of fluid volume excess and fluid volume deficit. Potassium Potassium is an electrolyte cation that is more prevalent inside cells than it is in extracellular fluid. It is used to transmit and conduct neurological impulses and to maintain cardiac rhythms. In order for a muscle to contract, the concentration of potassium inside the cell moves out and is replaced by sodium, which is the prevalent electrolyte out- side the cell (see Sodium). The concentration of potassium and sodium is maintained by the sodium-potassium pump found in cell membranes. Patients receive potassium from their diet and excrete potassium in urine (90%) and feces (8%). Serum potassium is measured to determine if the patient has a normal range of potassium. When this happens, the patient will exhibit specific signs and symptoms and the serum potassium will be outside the normal range. Hyperkalemia Hyperkalemia occurs when a patient has a serum potassium level greater than 5. A number of factors can cause this condition including: • Impaired renal excretion (most common). The nurse must respond quickly once signs and symptoms of hyperkalemia develop as the patient is at risk for seizures, injury related to muscle weakness, and cardiac arrhythmias. Hypokalemia Hypokalemia occurs when a patient has a serum potassium level of less than 3. The patient may have the following signs and symptoms when experienc- ing hypokalemia: • Leg cramps. The nurse must respond with the following interventions as the patient is a risk for injury related to muscle weakness and cardiac arrhythmias. Take with at least a half a glass of fluid (juice or water) because potassium is extremely irritating to the gastric and intestinal mucosa. The infusion should not exceed 10 to 20 mEq per hour or the patient may experience hyperkalemia and can experience cardiac arrest. Potassium Supplements Description 10% potassium chloride 20 mEq/15 mL oral 20% potassium chloride 40 mEq/16 mL oral 10% Kaochlor Oral Potassium triplex (potassium Oral, rarely used actetate, bicarbonate, citrate) Kaon (potassium gluconate) Enteric-coated tablet. Maintenance: 20 mEq in 1–2 divided dose Kaon-Cl (potassium chloride) Enteric-coated tablet. Maintenance: 20 mEq in 1–2 divided dose Slow-K (potassium chloride) Enteric-coated tablet. Maintenance: 8 mEq Kaochlor (potassium chloride) Correction: 40–80 mEq in 3–4 divided doses K-Lyte (potassium bicarbonate) Effervescent tablet.