Nephro wk2 hyperkalemia

Oral or IV of K+ causes hyperkalmeia by?

Increased intake of K+

Digitalis causes hyperkalmeia by?

Transcellular movement of K+

CKD causes hyperkalmeia by?

Impaired renal excretion of K+

AKI causes hyperkalmeia by?

Impaired renal excretion of K+

CKD causes hyperkalemia by?

Impaired renal excretion of K+

ACEIs cause hyperkalemia by?

Impaired renal excretion of K+

ARBs causes hyperkalmeia by?

Impaired renal excretion of K+

Acidosis causes hyperkalmeia by?

Transcellular movement of K+ & impaired renal excretion of K+

How does hemolysis affect potassium?

Causes erroneously elevated potassium

How does hyperkalmia effect EKG?

Causes peaked T waves & flattened P waves

What are underlying causes of hyperkalemia?

Renal insufficiency, Acidosis, missing dialysis appointments

What are the 3 potassium binders? (increases fecal K+ excretion). For chronic hyperkalemia.

Sodium polystyrene sulfonate (Kayexalate), Patiromer (Veltassa), Sodium zirconium cyclosilicate (Lokelma)

What are notes about sodium polystyrene sulfonate (kayexalate)? (SRS)

Give 3 hours before or after other medications, onset 1 hour, ADRs (GI obstruction, necrosis)

What are notes about Patiromer (Veltassa)?

Give 3 hours before or after other medications, don’t heat or add to heated foods, onset 7 hours

What are notes about sodium zirconium cyclosilicate? (SZC)

Give 2 hours before or after other medications, onset 1 hour, ADR (edema)

What are acute hyperkalmia treatments?

Calcium, albuterol, bicarbonate, insulin, glucose, K+ binders, dialysis

1st step of acute hyperkalemia?

Give IV calcium to stabilize cardiac membrane, does not decrease serum K+

What calcium is given to treat acute hyperkalemia?

Calcium chloride (3x more potent than calcium gluconate), given in central line unless code blue

2nd step of acute hyperkalemia?

Shift K+ into cells (using insulin)

How does Intracellular K+ shift in hyperkalemia treatment?

1st line: insulin regular 5-10 units IVP, if BG <250 give dextrose 50%. Adjuncts: sodium bicarbonate (metabolic acidosis) or nebulizer albuterol (B-agonist)

3rd step of acute hyperkalemia?

Remove K+ from body (using K+ binder or diuretic)

How is potassium removed in hyperkalemia treatment?

K+ binders (Sodium polystyrene sulfonate or Sodium zirconium cyclosilicate), furosemide (only if pt has good renal function), dialysis (if pt is already on dialysis)

What are causes of hyperkalemia?

Unresponsiveness to aldosterone, acidosis, Na+ K+ ATPase inhibition (B-blockers)

What are the steps to treat acute hyperkalemia?

(C A BIG KD) Calcium, bicarbonate, insulin, glucose, K+ binder, dialysis