Hyperkalaemia Flashcards
causes of hyperkalaemia
Post-operative AKI Drugs (ACEi, NSAIDs - cause AKI) DKA Excessive potassium treatment Tumour lysis Burns K sparing diuretics Addison's Crush injuries: 2 ways they casue hyperkalL: muscle breakdown and rhabdomyolis causing AKI
symptoms of hyperkalaemia
fast irregualr pulse chest pain weakness palpitations lightheadedness
3 ECG changes with hyperkalaemia
wide QRS
small/absent P wave
tall tented T waves. NB T NOT Q!!!!!!!!!!
drugs that cause hyperkalaemia
Potassium-Sparing Diuretics
Spironolactone
ACEi or ARBs
value for high K+
> 5.5
what do you give for hyperkalaemia?
5.5-6 = mild. no urgent action required. modify diet and review meds.
6-6.5 no ECG changes. Stop all potassium-containing/sparing drugs. Low potassium diet + hydration Monitor urine output. Treat hypotension. Give IV fluids if dehydrated Monitor renal function
>6.5 or ecg changes + >6 give all 3 of below: calcium gluconate (protects heart) actrapid (insulin) + dextrose -> drives K+ into cells neb salbutamol dialysis if all else fails
when is it an emergency
> 6.5 or > 6 with ECG changes
what MUST you do in anyone with high potassium
DO ECG!!!
treatment of hyperkal with ECG changes (include dose and route) ? how many can you give?
10ml 10% calcium carbonate IV
check ECG has changed. if not, can give up to 4 times, checking ECG after every dose
dose and route of ACTRAPID® and dextrose
10 units insulin
250mL GLUCOSE 10%
Give into a large vein over 30 minutes
first two things to do in pt with hyperkal
repeat test (often just an incorrect result) - can be on venous blood gas as is quicker! ECG - if changes, obviously treat as the result is likely to be right
if oligouric/renal disease, contact renal on call immediately
other drugs for hyperkalaemia
calcium resonium - sticks to K+ in bowel so it’s not absorbed. doesn’t work quickly but stops more potassium being absorbed
nebulised salbutamol
