Daryl Apostol
Etiology
Diagnostic tests
Causes
- Factors that increase K+ intake (e.g.
massive blood transfusion)
- Shift K+ from the cells into the ECF (e.g.
crushing injury)
- Decreases K+ excretion (e.g. oliguric)
- Any combination of the above
- Physical examination
- K+ serum level
- ECG/EKG
- Excessive/too-rapid IV K+ infusion
- Large transfusion of stored blood
- Massive doses of K+ penicillin G
- Acidosis caused by non-organic acids
- Insufficient insulin
- Crushing injury
- Cytotoxic drugs (tumor lysis syndrome)
- Hyperkalemic periodic paralysis
- Oliguria
- K+-sparring diuretics
- Adrenal insufficiency
- Renin-deficient states
- Drugs that reduce aldosterone effects
- Nephrotoxic drugs
Hyperkalemia
< 5.0 mEq/L
(Adults)
Pathogenesis:
One/com
-bination
causes of
hyperkalemia
occurs

concentration of
K+ ions in
ECF
Treatment:
- Low potassium diet
- Discontinue medications that increase K+ levels
- IV administration of glucose and insulin, sodium
bicarbonate (moves K+ in ECF back into ICF)
- Diuretics to excrete excess K+
- Medications - cation-exchange resins bind to K+
to be excreted via GI tract)
- Dialysis (last resort)
K+
concentration in the ICF is
normal or
above
normal level
Smooth &
skeletal
muscles
suppress
muscle activity
(Worsening)
Hypopolarized
skeletal muscles
cells exceed resting
membrane potential
threshold so when
released muscles
are not able to
contract again
Clinical
Manifestations
- Mild intestinal cramps
- Diarrhea
Clinical
Manifestations
- Muscle weakness
- Flaccid paralysis
- Cardiac dysrythmias