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Management of hyperkalemia

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  1. 1. Hyperkalemiahttp://crisbertcualteros.page.tl
  2. 2. Hyperkalemia:• Serum potassium level >5.5 mmol/L
  3. 3. Severity of hyperkalemia Mild: K level <6.0 mmol/L maybe normal or show only peaked T waves Moderate: K level 6.0 – 7.0 mmol/L (+) ECG may show peaked T waves Severe:• 7 – 8 mmol/L: (+)flattening of P waves & QRS widening;• 8 – 9 mmol/L: reveals fusion of QRS w/ T wave that leads to AV dissociation, ventricular dysrhythmias and death
  4. 4. Management of HyperkalemiaStep 1: Stabilization of membrane potentialo Ca Chloride/ Ca Gluconate 10%: 10-20mL IV over 3-10mino Note: use only when there is ECG evidence of hyperK, significant neuromuscular weakness or serum K >7mmol/L
  5. 5. Step 2. shift ECF K into ICFo Administer Dextrose/Insulin: 40-50 mL D50W IV over 5-10 min & 10 units HRo Administer Na Bicarbonate 1meq/Kg IV as bolus over 5min in patient w/ moderate to severe metabolic acidosisNote: most useful in severely acidotic patiento Salbutamol 5 mg + 3-4mL saline: nebulize over 10 min; use w/ caution in IHD
  6. 6. Step 3. Remove K from the bodyo Resonium A: 15gms PO 4-6 hourlyo HemodialysisStep 4. Prevent further K increaseo Review al medications: Span K, ACEI,B Blockerso Dietary review and advice
  7. 7. http://crisbertcualteros.page.tl