HYPERKALEMIA

  1. When you have too much potassium in your blood, it is called _____.
    hyperkalemia
  2. Hyperkalemia: serum potassium level greater than _ mEq/L
    5
  3. In older adults, there is an increased risk of hyperkalemia due to decreases in _____ and ______.
    renin and aldosterone
  4. Hyperkalemia is often caused by ______ (treatment-induced)
    causes
    iatrogenic
  5. T or F:  hyperkalemia is less common than hypokalemia
    T
  6. T or F: Hyperkalemia is usually more dangerous because cardiac arrest is more frequently associated with high serum potassium levels
    T
  7. What are the major causes of hyperkalemia? (3)
    • ☠ decreased renal excretion of potassium,
    • ☠ rapid administration of potassium
    • ☠ movement of potassium from the ICF compartment to the ECF compartment
  8. Patients with _______ or ________ are at risk for hyperkalemia because of a lack of aldosterone.
    hypoaldosteronism or Addison disease
  9. Medications have been identified as a probable contributing factor in more
    than 60% of hyperkalemic episodes. Medications commonly implicated are: (8)
    • KCl,
    • heparin,
    • ACE inhibitors,
    • NSAIDs,
    • beta-blockers,
    • cyclosporine,
    • tacrolimus,
    • and potassium-sparing diuretics
  10. low blood pH
    acidosis
  11. a false hyperkalemia
    pseudohyperkalemia
  12. Contributing factors of hyperkalemia: (9)
    • ★Pseudohyperkalemia,
    • ★oliguric kidney injury,
    • ★use of potassium conserving diuretics in patients with renal insufficiency,
    • ★metabolic acidosis,
    • ★Addison disease,
    • ★crush injury,
    • ★burns,
    • ★stored bank blood transfusions,
    • ★rapid IV administration of potassium,
    • certain medications such as ACE
    • inhibitors, NSAIDs, cyclosporine
  13. Signs and Symptoms of hyperkalemia:
    • ★Muscle weakness,
    • ★tachycardia →bradycardia,
    • ★arrhythmias,
    • ★flaccid paralysis,
    • ★paresthesias,
    • ★intestinal colic,
    • ★cramps,
    • ★abdominal distention,
    • ★irritability,
    • ★anxiety.

    ECG: tall tented T waves, prolonged PR interval and QRS duration, absent P waves, ST depression
  14. The most important consequence of hyperkalemia is its effect on the _____.
    myocardium
  15. Assessment and Diagnostic Findings

    _______ and _______ are crucial to the diagnosis of hyperkalemia
    Serum potassium levels and ECG changes
  16. Medical Management:

    In disorders involving potassium level changes, an ___ should be obtained immediately
    ECG
  17. In nonacute situations, restriction of dietary ______ and _____ may correct the imbalance
    potassium and potassium containing medications
  18. Administration, either orally or by retention enema, of _______ (e.g., sodium polystyrene sulfonate) may be necessary
    cation exchange resins
  19. T or F: The use of cation exchange resins does not require normal bowel function
    F - The use of cation exchange resins requires normal bowel function
  20. T or F: The use of cation exchange resins does not require normal bowel function
    F: The use of cation exchange resins requires normal bowel function
  21. ______ is another oral agent that is a potassium removing resin used to treat hyperkalemia.
    Patiromer sorbitex calcium
  22. Side effects of Patiromer sorbitex calcium: (3)
    GI intolerance, hypomagnesemia, and edema
  23. Emergency Pharmacologic Therapy:

    If serum potassium levels are dangerously elevated, it may be necessary to administer IV _____.
    calcium gluconate
  24. Emergency Pharmacologic Therapy

    The ECG should be continuously monitored during administration; the appearance of _____ is an indication to stop the infusion
    bradycardia
  25. Emergency Pharmacologic Therapy
    IV administration of ______  may be necessary in severe
    metabolic acidosis to alkalinize the plasma, shift potassium into the cells, and furnish sodium to antagonize the cardiac effects of potassium
    sodium bicarbonate
  26. Nursing Management:

    Patients at risk for potassium excess (e.g., those with kidney disease) need to be identified and closely monitored for signs of ______.
    hyperkalemia
  27. Nursing Management:

    The nurse monitors for: (9)
    • ★I & O
    • ★ vital signs
    • ★ observes for signs of muscle weakness and arrhythmias
    • ★ presence of paresthesias and GI symptoms (nausea and intestinal cramping)
    • ★ Serum potassium levels
    • ★BUN
    • ★Serum creatinine
    • ★Serum glucose
    • ★ABG values
  28. Preventing Hyperkalemia:

    What are the measures to be taken to prevent hyperkalemia in patients at risk?
    when possible, by encouraging the patient to adhere to the prescribed potassium restriction.
  29. Potassium-rich foods to be avoided include:
    many fruits and vegetables, legumes, whole-grain breads, lean meat, milk, eggs, coffee, tea, and cocoa
  30. foods with minimal potassium content include:
    butter, margarine, cranberry juice or sauce, ginger ale, gumdrops or jelly beans, hard candy, root beer, sugar, and honey
  31. Labels of cola beverages must be checked carefully because some are high in ____ and some are not
    potasisum
  32. when administering potassium solutions,  IV administration should only be via an _____.
    infusion pump
  33. T or F: potassium-conserving diuretics, potassium supplements,
    and salt substitutes should not be given to patients with kidney injury
    T
Author
ekmg
ID
365703
Card Set
HYPERKALEMIA
Description
Updated