Hyperkalaemia Flashcards
1
Q
What is hyperkalaemia?
A
High serum potassium; associated with cardiac arrhythmias
2
Q
What are some conditions that can cause hyperkalaemia?
A
- Acute kidney injury
- Chronic kidney disease
- Rhabdomyolysis
- Adrenal insufficiency
- Tumour lysis syndrome
3
Q
What are some medications that can cause hyperkalaemia
A
- Aldosterone antagonists (spironolactone and eplerenone)
- ACE inhibitors
- Angiotensin II receptor blockers
- NSAIDs
- Potassium supplements
4
Q
How may hyperkalaemia present?
A
When present, the symptoms of hyperkalemia are nonspecific and predominantly related to muscular or cardiac function - fatigue, muscle weakness, palpatations/chest pain
5
Q
What investigations are required in hyperkalaemia?
A
Bloods
ECG
6
Q
What bloods are required in hyperkalaemia?
A
U+Es - potassium, creatinine, urea, eGFR
7
Q
What will ECG show in hyperkalaemia?
A
- Tall peaked T waves
- Flattening or absence of P waves
- Broad QRS complexes
8
Q
What is the 1st line management of hyperkalaemia?
A
- Cardiac monitor and IV access
- insulin and dextrose infusion and IV calcium gluconate
- 10 mls 10% calcium gluconate (2-3 mins) - protects myocardium
- Insulin (actrapid 10 units) with 50mls 50% dextrose (30 mins) - moves K+ back into cells
9
Q
What are some other management options in hyperkalaemia?
A
- Salbutamol neb (90 mins) - temporarily drives potassium into cells
- Sodium bicarbonate if acidotic
- In chronic hyperkalaemia (not used in acute setting) - calcium resonuim to prevent absorption from GI tract
- IV fluids can be used to increase urine output, which encourages potassium loss from the kidneys (but don’t fluid overload patients with renal failure)
10
Q
A
