Hyperkalaemia Flashcards
1
Q
What are the serum levels for hyperkalaemia?
*think mild, moderate, severe
A
- Mild
- 5.5-6.5
- Moderate
- 6.5-8.0
- Severe
- more than 8.0
2
Q
What conditions causes hyperkalaemia?
A
- AKI or CKD
- Rhabdomyolysis
- Metabolic acidosis from DM
- Addison’s disease
- Tumour lysis syndrome
3
Q
What medications causes hyperkalaemia?
A
- Aldosterone antagonists (spironolactone and eplerenone)
- ACE inhibitors
- Angiotensin II receptor blockers
- NSAIDs
- Potassium supplements
- Suxamethonium
*
4
Q
What are the complications of hyperkalaemia?
A
- Cardiac arrythmias
- VF
5
Q
What is the Px of ECG changes in hyperkalaemia?
A
- Normally, K leave cell as con. gradient steep
- Hyperkalaemia > tendency of K to leave cells decreases
- Cell membranes depolarised - resting membrane potential less negative
6
Q
What are the ECG changes of hyperkalaemia?
A
- Tented T waves
- Flattening or absence of P waves
- Broad QRS complexes
- Sinusoidal
7
Q
What are the Sx of hyperkalaemia?
A
- fast, irregular pulse
- chest pain
- weakness
- palpitations
- light headedness
*
8
Q
How would you Mx hyperkalaemia?
* mx based on K less than 6, Kmore than 6 and K more than 6.5
A
- Less than or equal to 6 + stable renal function
- x need urgent care
- change in diet and medications
- Equal to or more than 6 + ECG changes
- need urgent tx
- Equal to or more than 6.5
- need urgent tx
9
Q
What is the mainstay tx for hyperkalaemia?
A
- insulin and dextrose infusion
- IV calcium gluconate
10
Q
What are the other options for lowering serum K?
A
- Nebulised salbutamol
- IV fluids can be used to increase urine output - encourages potassium loss from the kidneys
- Oral calcium resonium - draws potassium out of the gut and into the stools
- Sodium bicarbonate - drives potassium into cells as the acidosis is corrected.
- Dialysis
