Hyperkalemia

Question 1

what value is considered hyperkalemia?

Answer 1

above 5.0

Question 2

what are some causes of hyperkalemia?

Answer 2

• excess potassium related to kidney impairment/injury
• use of potassium sparing diuretics with renal insufficiency, hypoaldonsteronism, Addison’s disease
• rapid administration of IV fluids containing potassium
• certain medications like ACE inhibitors, cyclosporine, and NSAIDS

Question 3

in the pneumonic “MURDER” for signs and symptoms of hyperkalemia, what does the “M” mean?

Answer 3

muscle weakness

Question 4

in the pneumonic “MURDER” for signs and symptoms of hyperkalemia, what does the “U” mean?

Answer 4

urine output little to none (renal failure)

Question 5

in the pneumonic “MURDER” for signs and symptoms of hyperkalemia, what does “R” mean?

Answer 5

respiratory failure (from muscle weakness)

Question 6

in the pneumonic “MURDER” for signs and symptoms of hyperkalemia, what does the “D” mean?

Answer 6

decreased cardiac contractility (weak pulse/low HR)

Question 7

in the pneumonic “MURDER” for signs and symptoms of hyperkalemia, what does the “E” mean?

Answer 7

early: muscle twitches/cramps

Question 8

in the pneumonic “MURDER” for signs and symptoms of hyperkalemia, what does the second “R” mean?

Answer 8

rhythm changes: tall peaked T waves, prolonged PR wave

Question 9

what are some important things to know for nursing management of hyperkalemia?

Answer 9

• obtain ECG immediately to evaluate effects on the heart, monitor frequently
• obtain serum K level, monitor frequently
• stop any IV infusions of K, if infusing
• discuss dietary considerations
• review medications
• monitor BUN, serum creatinine, serum glucose, and ABGs

Question 10

Which medication will you administer with dangerously elevated levels of potassium?

Answer 10

calcium gluconate