Hyperkalemia Flashcards
Normal potassium range
3.5-5.1
What is considered hyperkalemic levels
> 7.70
What is hyperkalemia on a cellular level
Large amounts of potassium have congregated outside the cell instead of inside the cell
What is potassium responsible for
Nerve impulse conduction, muscle contraction (gives us our normal heart rhythm)
Causes of hyperkalemia
“Body CARED too much for K+”
- Cellular movement of K+ from inside to outside cell (burns, tissue damage, acidosis)
- adrenal insufficiency (Addison’s)
- renal failure
- excessive potassium intake
- drugs (K+ sparing aldactone, triamterene, ace inhibitor, NSAIDs)
S&S of hyperkalemia
MURDER
Muscle weakness
Urine production low or absent
Respiratory failure (muscle weakness/seizures)
Decreased cardiac contradictory (weak pulse, low bp)
Early signs of muscle twitching/cramps (very bad = profound weakness, flaccid)
Rhythm changes
How does hyperkalemia affect heart rhythm
tall peaked t wave
flat or absent p waves
wide QRS
prolonged PR interval
Interventions
- Monitor cardiac, respiratory, neuromuscular, GI status (cardiac and oxygen monitoring)
- stop IV potassium infusion or hold supplements if ordered
- initiate K+ restrictive diet
- prepare pt for dialysis
- kayexelate sometimes order PO or enema
- doctor may order lasix or other k+ wasting drugs
- doctor may order hypertonic solution of glucose + insulin
What foods are not allowed on a K+ restrictive diet
Potatoes, pork Oranges Tomatoes Avocados Strawberries Spinach fIsh mUshrooms Musk melon -> cantaloupe Carrots Raisins Bananas
What does Kayexalate do in the body
Cause GI sodium absorption which promotes k+ excretion
What does a hypertonic solution of glucose + regular insulin do in the body
Potassium will get pulled back into the cell
Examples of K+ wasting diuretics
Loop diuretics + thiazide diuretics
Thiazide Chlorothiazide Chlorthalidone Hydrochlorothiazide Indapamide Metolazone
Loop Bumetanide Ethacrynic acid Furosemide Torsemide
