HYPERKALEMIA (ELECTROLYTE IMBALANCE)
HYPERKALEMIA It is an elevated level potassium(k+) in blood(above 5.5mEq/L) Normal potassium level 3.5 - 5mmol/L (3.5 - 5 mEq/L) Potassium level >8.0 mEq causes diastolic arrest CAUSES: Pseudo hyperkalemia : fist clenching, narrow bore needle, cooling of sample, TLC↑, platelet↑, RBC↑ Acidosis,Trans-cellular shift CKD/AKI Aldosterone↓ - Addison disease, histoplasmosis, HIV, waterhouse frederickson syndrome Gordon syndrome- gain of NACL cotransport WORKUP: Increase potassium ECG: a)Tall peaked T wave b)ST segment depressed c)P wave - wide, flat d)QRS widened TREATMENT: Antagonism: Ca gluconate (usually used),Ca chloride (best) Redistribution: Insulin drip with 50% dextrose,salbutamol nebulization Removal of potassium: Furosemide,Resin sodium polystyrene sulphonate, PATIROMER(potassium binding agent), ZS - 9(sodium zirconium cyclosilicate)