Hyperkalemia

Clinical Picture
The patient may have:
-Muscular weakness
-Cardiac dysrhythmias
-ECG abnormalities
-Nausea

Immediate Intervention
-Assess VS; note cardiac rate & rhythm
-Administer oxygen
-Assess for patient IV access
-Assess recent laboratory results (BUN, creatinine,electrolytes)
-Notify physicianor NP
-Document patient's status,phone call to physician or NP & physician or NP response

Focused Assessment
-Monitor VS, & assess cardiac rhythm if available
-Assess LOC & orientation
-Assess musculoskeletal function
-Assess previous 2 days I&O

Stabilizing & Monitoring
-Obtain IV access
-Administer potassium-binding resins (Kayexalate) orally or rectally
-Monitor cardiac rhythm, I&O,serial potassium levels & other laboratory test
-Chart patient status & convey to physician

Be Prepared To
-Set up cardiac monitoring
-Administer IV calcium,sodium bicarbonate,insulin & glucose or furosemide per order
-Order or obtain laboratory test
-Order a 12-lead ECG
-Transfer to telemetry unit

Possible Etiologies
-Medication
-Chemotherapy
-Acute or chronic renal failure
-Hypoaldosteronism trauma
-Hemolysis
-Digitalis poisoning
-Acidosis
-Burns
-Insulin deficiency
-Uncontrolled hyperglycemia
-Excessive use of salt substitutes
-Metabolic acidosis