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Understanding and Managing Hyperkalemia

Oct 23, 2024

Hyperkalemia Overview

Presented by: Sarah from Register Nurse RN

Introduction

  • Discussion on hyperkalemia (high potassium in the blood).
  • Encouragement to review a previous video on hypokalemia.
  • Recommendation to take a quiz on hyperkalemia and hypokalemia on the website.
  • Normal Potassium Level: 3.5 to 5.1 mEq/L (anything above 7 mEq/L is dangerous).

Understanding Hyperkalemia

  • Potassium's role mainly inside cells (intracellular).
  • Blood tests measure extracellular potassium levels.
  • High extracellular potassium levels cause hyperkalemia.
  • Potassium is crucial for nerve conduction and muscle contraction.

Causes of Hyperkalemia (Mnemonic: CARED)

  1. Cellular movement of potassium from intracellular to extracellular due to:

    • Burns
    • Tissue damage
    • Acidosis

  2. Adrenal insufficiency (e.g., Addison's disease).

  3. Renal failure (frequent in dialysis patients).

  4. Excessive potassium intake.

  5. Drugs (potassium-sparing diuretics, ACE inhibitors, NSAIDs).

Signs and Symptoms (Mnemonic: MURDER)

  1. Muscle weakness
  2. Urine output low or absent (related to renal failure)
  3. Respiratory failure (muscle weakness, seizures)
  4. Decreased cardiac contractility (weak pulse, low blood pressure)
  5. Early signs: Muscle twitching and cramps
  6. Rhythm changes in EKG
    • Tall peaked T-waves
    • Flat/absent P-waves
    • Wide QRS complexes
    • Prolonged PR interval
    • Leads to cardiac arrest (e.g., V-fib, V-tach)

EKG Changes in Hyperkalemia

  • Normal EKG: Distinct P-wave, QRS complex, and T-wave.
  • Abnormal (Hyperkalemia EKG):
    • Flat or absent P-wave
    • Prolonged PR interval
    • Wide QRS complex
    • Tall T-wave

Interventions

  • Monitor: Cardiac, respiratory, neuro, muscular, and GI status.
  • Actions:
    • Stop IV potassium infusions and PO supplements.
    • Initiate a potassium-restricted diet.
    • Prepare for dialysis if necessary.
    • Administer Kayexalate (oral or enema) for sodium absorption and potassium excretion.
    • Administer Lasix or other potassium-wasting diuretics.
    • Use hypertonic solution of glucose and insulin to shift potassium into cells.

Conclusion

  • Encouragement to visit the website for quizzes and resources.
  • Suggestion to subscribe to the YouTube channel for more tutorials.

Full transcript