Renal Flashcards
nl for serum K+
3.5 - 5.0
sources of increased intake of K+ (2)
supplements
IV
mechanical trauma from venipuncture can cause __,
in which case you will see __
pseudohyperkalemia
red serum
hyperkalemia with red serum related to __ is more common than pseudohyperkalemia
true severe intravascular hemolysis
5 causes of hyperkalemia
venipuncture
exercise
cooling of sample/deterioration of sample
thrombocytosis
severe leukocytosis
3 causes of intracellular to extracellular K+ shifts
breakdown of cells
acidosis
insulin deficiency or resistance
how does insulin affect K+
causes K+ entry into cells
meds that cause hyperkalemia
ACEIs
ARBs
NSAIDs
spironolactone
bb
digitalis
succinylcholine
bactrim
amiloride
K+ supplements
how does hyperkalemia affect the heart
membrane excitability → elevated depolarization threshold → depressed cardiac fxn
sx of hyperkalemia
n/v
palpitations
lethargy
confusion
paresthesias
muscle weakness
paralysis
arrhythmias/death
2 most important labs for eval of hyperkalemia
BMP
EKG
+/- ABG
EKG changes of hyperkalemia in order of early to late
- peaked T waves
- flattened P wave
- wide QRS
- sine wave
3 most serious sx of hyperkalemia
muscle weakness
paralysis
arrhythmias
tx for hyperkalemia + EKG changes
IV calcium gluconate
continuous cardiac monitoring
drive K+ back into cell/remove K+ from body
3 temporary options to drive K+ back into the cell
insulin + glucose
SABA → albuterol
IV sodium bicarbonate
all pt w. hyperkalemia should get
insulin + glucose
3 options to remove K+ from the body
GI cation exchanger
diuretics + saline
hemodialysis
med that binds K+ in the GI tract in exchange for other cations so that it is excreted in feces
GI cation exchanger
2 ex of GI cation exchangers
Kayexelate
Patiromer (Valtassa)
what diuretic is first line for hyperkalemia
loop → Lasix
tx for hyperkalemic pt w. severe renal impairment
hemodialysis
CKD is defined as declining kidney fxn for __ or more months
3
2 mc causes of CKD
DM
HTN
gs for GFR measurement
inulin clearance
