Hyperkalemia

potassium above ___ indicates hyperkalemia

5.0 mEq/L

potassium at or above ___ is a medical emergency

6.5 mEq/L

what body system is most at risk in hyperkalemia?

the cardiac electrical system

• arrhythmias can lead to cardiac arrest

diseases that cause hyperkalemia?

acute kidney failure, chronic kidney disease, ESRD, addison’s disease

what endocrine disorder can cause hyperkalemia?

addison’s disease (low aldosterone)

medications that can cause hyperkalemia

• ACE inhibitors

• NSAIDs

• potassium-sparing diuretics (e.g., spironolactone)

why do burns cause hyperkalemia?

potassium inside cells leak out because they are destroyed

what lab issue can falsely elevate potassium?

hemolyzed specimen (pseudohyperkalemia)

• repeat the lab and correlate with the patient

there are ____ deep tendon reflexes in hyperkalemia

increased

expected cues in hyperkalemia

• muscle weakness, twitching, cramps

• little urine output

• resp failure

• decreased cardiac contracility/rhythm changes

• diarrhea

GI cues in hyperkalemia

• diarrhea

• hyperactive bowel sounds

• abdominal cramping

early clues for hyperkalemia

muscle twitching/cramping

urinary output pattern in hyperkalemia

oliguria or anuria, especially with renal failure

why does hyperkalemia cause respiratory failure?

progressive skeletal muscle weakness or paralysis impairs ventilation

vital sign trends in hyperkalemia

everything is low

• weak pulse

• low heart rate

• low blood pressure

first nursing priorities in hyperkalemia

• identify and treat the cause

• continuous cardiac monitoring (most important)

• obtain a 12-lead EKG as prescribed

most important nursing action for patients with hyperkalemia

monitor cardiac rhythm

• 12 lead EKG

how do you reduce potassium exposure during treatment?

• stop IV potassium

• hold oral potassium

• potassium-restricted diet

what meds shift potassium into cells?

IV dextrose, regular insulin

what medication removes potassium via the GI tract (stool)?

sodium polystyrene sulfonate (kayexalate)

type of diuretics used for hyperkalemia

loop diuretics

• if renal function is adequate

when is dialysis indicated for hyperkalemia?

with renal failure or persistent hyperkalemia despite therapy

diet teaching for hyperkalemia

restrict high-potassium foods

• bananas; citrus; melons; tomatoes; potatoes; spinach; avocados; dairy; dried fruits; beans