Potassium

is the major intracellular electrolyte; in fact, 98% of

the bodys potassium is inside the cells. The remaining
2% is in the ECF and is important in neuromuscular
function.
Potassium influences both skeletal and cardiac
muscle activity.
The normal serum potassium concentration ranges
from 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)

Hyperkalemia
Greater than 5.0 mEq/L
Occurs in patient with normal renal function.
Often caused by iatrogenic (treatment-induced) causes.
Less common than hypokalemia, it is usually more
dangerous, because cardiac arrest is more frequently
associated with high serum potassium levels.

Signs and Symptoms

Muscle
weakness

cramps

tachycardia

Abdominal
distention

Flaccid
paralysis

irritability

paresthesia

anxiety

Intestinal
colic

dysrhythmias

ECG Changes
Tall tended T waves
Prolonged PR interval and QRS
duration
Absent P waves
ST depression

ECG Changes

PATHOPHYSIOLOGY

Diagnostic Test
ECG (Electrocargiogram)
Serum Potassium Levels
Arterial blood gas analysis may
reveal both metabolic and respiratory
acidosis

Medical Management
Calcium Gluconate antagonizes the action of
hyperkalemia in the heart
Sodium Bicarbonate to alkalinize the plasma
, cause a temporary shift of potassium into the
cells and furnish sodium to antagonize the
cardiac effects of potassium
Beta 2 antagonist (Albuterol) highly effective
in decreasing potassium

Nursing Management
Monitor ECG
Monitor vital signs
Monitor serum potassium level as well as BUN, cre,
glucose and arterial blood gas
Observe for signs of muscle weakness and
dysrhythmias
Prescribe sodium restriction
Avoid foods rich in potassium such as legumes,
whole grain breads, meat, milk, eggs, coffee, tea and
cocoa