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Hyperkalemia

Merima Bucaj, DO, FAAFP Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Hyperkalemia is a common electrolyte disorder that may be defined as a plasma potassium (K) concentration >5.5 mEq/L (>5 mmol/L).

  • Hyperkalemia depresses cardiac conduction and c...

DIAGNOSIS

Serum potassium level greater than the normal range (3.5–5.0 mEq/L) 

HISTORY

  • Neuromuscular cramps

  • Abdominal pain

  • Palpitations

  • Myalgias

  • Numbness

  • Muscle weakness or paralysis

PHYSICAL EXAM

  • Decreased de...

TREATMENT

MEDICATION

  • Stabilize myocardial membranes. Initial treatment with calcium gluconate IV 1,000 mg (10 mL of 10% solution) over 2 to 3 minutes (3)[A]

    • With constant cardiac monitoring

    • Can repeat af...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Reduction of plasma K should begin within the first hour of treatment initiation.

  • Serum K levels should be rechecked every 2 to 4 hours until the...

REFERENCES

1
Nilsson E, Gasparini A, Ärnlöv J, et al. Incidence and determinants of hyperkalemia and hypokalemia in a large healthcare system. Int J Cardiol.  2017;245:277–284.
2
Palmer BF, Clegg DJ...

ADDITIONAL READING

SEE ALSO

  • Addison Disease: Hypokalemia

  • Algorithm: Hyperkalemia

CODES

ICD10

E87.5 Hyperkalemia 

ICD9

276.7 Hyperpotassemia 

SNOMED

  • 14140009 hyperkalemia (disorder)

  • 237847005 Hyperkalemic acidosis

  • 237849008 Drug-induced hyperkalemia (disorder)

CLINICAL PEARLS

  • Emergency and urgent management of hyperkalemia takes precedence to a thorough diagnostic workup. Urgent treatment includes stabilization of the myocardium with calcium gluconate to pr...

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