Hyperkalemia

signs and treatment

Hyperkalemia above 3.5-5
meq/l
 Conservative- Low K diet
 What foods are high in K+

Above 6.0 get serious

Above 6.5 get aggressive

Signs of Hyperkalemia
• peaked T waves -- K level go around 6 meq/L.
• prolongation of PR interval --K level going around or
above 7 meq/L.
• Absent P wave with widened QRS complex -- is a
very dangerous sign. It means that atrial activity is lost
and stage is set for ventricular tachycardia/fibrillation. It
is usually seen at level around 8-9 meq/L.

• Ventricular tachycardia/fibrillation is the price you pay of

ignoring above changes on monitor.
Chronic Renal Failure- Emergency
Management of Hyperkalemia
1.Ca+ chloride or Ca+ gluconate (restoring normal
gradient between threshold potential and resting
membrane potential)
2.Kaexalate- resin orally or rectally takes hours
3.GIK -- intravenous injection of 10-15 units of
regular insulin along with 50 ml of 50% dextrose
(lasts a few hours while doing more permanent
measures)
4. Na+ HCO3 therapy (e.g. 1 ampule (50 mEq)
infused over 5 min) shiftings potassium into the
cell.
Management of Hyperkalemia
5. Ventolin- (15 mg albuterol via
nebulizer)
 - Albuterol works to lower potassium
concentrations by stimulating the release of
insulin. This release of insulin shifts the
potassium into the cells thus lowering the
potassium level.

 - Albuterol also stimulates the Na/k+ pump

causing potassium to be shifted into the cells.