HyperKalemia Flashcards
1
Q
A patient presents with a gun shot wound to the thorax necessitating exploratory thoracostomy. The patient’s serum K⁺ level is 5.7 mg/dL, what do you do?
A
- Emergent surgery so proceed and treat the hyperkalemia
If the surgery was not emergent you would treat the K⁺ til it was below 5 mg/dL.
S13 extra
2
Q
What are hyperkalemia’s effects on on EKG?
A
- Peaked “T” Waves
- P wave disappearance
- prolonged QRS complex
- sine waves
- asystole
Renal S13
3
Q
What is the treatment for hyperkalemia?
A
“C BIG K”
- Calcium gluconate (1° treatment)
- Bicarbonate
- Insulin
- Glucose
- Kayexelate
Dialyze within 24h prior to surgery
Avoid Succs, hypoventilation, LR & K+ containing IV fluids
Renal S14
4
Q
What causes Hyperkalemia?
A
- Renal failure
- Hypoaldosteronism
- Drugs that inhibit RAAS
- Drugs that inhibit K+ excretion
- Depolarizing NMB (Succs)
- Acidosis (Respiratory/Metabolic)
- Cell death (trauma, tourniquet)
- Massive blood transfusion
S13
5
Q
What are s/s of Hyperkalemia?
A
- Chronic may be minimally symptomatic (malaise, GI upset)
- Skeletal muscle paralysis,↓fine motor
- Cardiac dysrhythmias
S13
