Acute Kidney Injury Pt. 2 Flashcards
What is the most dangerous electrolyte imbalance in AKI?
Hyperkalemia (↑ K⁺ > 5.0 mEq/L)
→ can cause fatal cardiac arrhythmias
What ECG changes occur in hyperkalemia?
- Peaked, tall T waves
- Widened QRS
- Absent P wave
What are the treatments for hyperkalemia?
- Hemodialysis (most effective for severe cases)
- Calcium
- IV insulin
- Cation Exchange Resin
- Sodium Bicarbonate
Which treatment for hyperkalemia works fastest? Why?
- Hemodialysis
- Directly removes K⁺ from the blood in minutes
Which treatment is slowest? Why?
- Cation Exchange Resin
- Takes hours to remove K⁺ via stool
Why is calcium given in hyperkalemia?
counteracts the negative effects that potassium has on the heart
What electrolyte imbalance can calcium cause?
Hypercalcemia
What is extravasation of calcium?
Leakage of IV calcium into tissues → causes necrosis
How can nurses prevent extravasation?
- Use a large vein
- Monitor IV site
- Infuse slowly
Why is insulin given in hyperkalemia?
- shifts K⁺ into cells
- ↓ K⁺ in the extracellular space
Why is glucose given with insulin?
To prevent hypoglycemia
How does Cation Exchange Resin treat hyperkalemia?
- exchanges Na⁺ for K⁺ in the intestines
- binds K⁺ in the intestines and eliminates it in stool
What are two major side effects of Cation Exchange Resin?
hypokalemia and hypernatremia
What are hypernatremia symptoms?
- thirst
- confusion
- muscle twitching
- seizures
What are the routes of administration for Cation Exchange Resin?
orally or via enema
Why is sodium bicarbonate given in hyperkalemia?
Treats acidosis and shifts K⁺ into cells
What are the potential side effects of sodium bicarbonate?
pulmonary edema and/or CHF
What dietary restrictions should be followed in hyperkalemia?
- Avoid high K⁺ foods (toes and does)
- Limit salt substitutes
- Encourage K⁺ binding foods (berries, rice, cauliflower)
What are key prevention strategies for AKI?
- Avoid nephrotoxic toxins/meds
- Monitor BUN and serum creatinine levels
- Withhold Metformin prior to procedures requiring IV contrast
