Hyperkalemia

Question 1

Hyperkalemia Ranges

Answer 1

Mild: 5.2-5.9

Mod: 6-6.4

Severe: >6.5

Question 2

Severe Tx

Answer 2

1. Ca gluconate 2g IV over 10 min (stabilize myocardium)
2. Insulin 10 units IV or 0.1 units/kg (shift K intracellularly)
   -Give with dextrose 50% to avoid hypoglycemia (BG <300)
   -<150 then 25 g x2 doses, 150-300 then 25 g x1 dose (over 5 min)
3. Furosemide 20-40 mg IV push x1 dose (remove K)

Question 3

Moderate Tx

Answer 3

-No ECG changes with 6-6.4

1. Insulin 10 units IV or 0.1 units/kg (shift K intracellularly)
   -Give with dextrose 50% to avoid hypoglycemia (BG <300)
   -<150 then 25 g x2 doses, 150-300 then 25 g x1 dose (over 5 min)
2. Furosemide 20-40 mg IV push x1 dose (remove K)

Question 4

Mild Tx

Answer 4

Furosemide 20-40 mg IV push x1 dose (remove K)
or
Kayexelate 15-30 g every 4-6 hours as needed