§ Hyperkalemia is a blood potassium level § Increased total body potassium: IV
greater than 5.0 mEq/L potassium administration, salt
§ It is the result of an increased intake of substitutes, blood transfusion
potassium, movement of potassium out § ECF shift: insufficient insulin, acidosis
of the cells, or inadequate renal (diabetic ketoacidosis), tissue catabolism
excretion (sepsis, burns, trauma, surgery, fever)
§ It is uncommon in clients who have § Hypertonic states: uncontrolled
adequate kidney function diabetes mellitus
§ Potentially life-threatening due to the § Decreased excretion of potassium:
risk of cardiac arrhythmias and cardiac kidney failure, sever dehydration,
arrest potassium-sparing diuretics, ACE
§ Severe dehydration inhibitors, adrenal insufficiency
§ Insufficient insulin/uncontrolled § Age: older adult clients at greater risk
diabetes mellitus due to decreased kidney function and
medical conditions resulting in the use
of salt substitutes
Expected Findings in Adults Diagnosis Nursing Care
§ Implement continuous ECG monitoring
§ Vital signs: slow, irregular pulse,
hypotension
Hyperkalemia § Decrease potassium intake
(K+ >5.0 mEq/L) o Stop infusion of IV potassium
§ Neuromusculoskeletal: irritability,
confusion, weakness with ascending o Withhold oral potassium
flaccid paralysis, paresthesia, lack of o Provide a potassium restricted
reflexes diet
§ GI: increased motility, diarrhea, § If potassium levels are extremely high,
abdominal cramps, hyperactive bowel
Potassium dialysis might be required
sounds § Potassium is the major cation in ICF § Treat underlying problem
§ Plays a vital role in: § Medications
o Cell metabolism o Potassium-wasting diuretics, such
o Transmission of nerve impulses as furosemide (Lasix)
o Functioning of cardiac, lung, and o Sodium polystyrene sulfonate
muscle tissues (kayexaltate)
o acid-base-balance o Insulin