Hyperkalemia (Elevated Potassium)

Photo by cottonbro on Pexels.com

Hyperkalemia

Copy & paste the smart phrase to your eMAR

Hyperkalemia
-DDx includes: Acute tubular necrosis vs ACE-I/K+ sparing diuretics vs digitalis toxicity vs rhabdomyolysis vs tumor lysis syndrome vs pseudohyperkalemia, 
-Redraw labs.
-Stat EKG.
-Admit to telemetry. Monitor for small or absent p wave, prolonged PR interval, augmented R wave, wide QRS, and peaked T waves.
-Obtain serum blood urea nitrogen and creatinine to assess renal function, and UA to screen for renal disease. Urine potassium, sodium, and osmolality may also be helpful in evaluating the cause. 
-Calcium chloride if cardiac arrest, otherwise calcium gluconate.
-10units regular insulin with 50ml of 50% Dextrose solution (D50). Monitor for hypoglycemia. 
-10% Dextrose infusion at 50-75ml/hr, begin drip if needed.
-Albuterol treatment.
-Sodium bicarbonate.
-Consider loop/thiazide diuretic +/- Patiromer.
-Hemodialysis if ESRD.
-Cardiology and nephrology consult if not improving.