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Hyperkalemia

Reviewed 06/2019
 


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

HISTORY

  • Neuromuscular cramps

  • Abdominal pain

  • Palpitations

  • Myalgias

  • Numbness

  • Muscle weakness or paralysis

PHYSICAL EXAM

  • Decreased deep tendon reflexes

  • Flaccid paralysis of extremities

DIAGNOSTIC TESTS & INTERPRETATION

TREATMENT

MEDICATION

  • Stabilize myocardial membranes; initial treatment with calcium gluconate IV 1,000 mg (10 mL of 10% solution) over 2 to 3 minutes (2)[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
Palmer BF, Clegg DJ. Hyperkalemia. JAMA.  2015;314(22):2405–2406. [View Abstract on OvidMedline]
2
Viera AJ, Wouk N. Potassium disorders: hypokalemia and hyperkalemia. Am Fam Physician....

ADDITIONAL READING

  • Harel Z, Harel S, Shah PS, et al. Gastrointestinal adverse events with sodium polystyrene sulfonate (Kayexalate) use: a systematic review. Am J Med.  2013;126(3):264.e9–264.e24...

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 precedent to a thorough diagnostic workup. Urgent treatment includes stabilization of the myocardium with calcium gluconate to pro...

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