Hyperkalemia Management

Pseudohyperkalemia: 1. Hemolyzed sample 2. Blood drawn from a site/line where potassium or TPN is infusing 3. Extreme thrombocytosis or leukocytosis

Assess/Stabilize the Heart:

 • Order a STAT EKG to assess cardiac conduction (below). 

 • Order calcium to stabilize heart if EKG changes present or in severe K elevation.

Decrease K:

 • FAST (20 minutes-hour) -Shift intracellularly (does not decrease total body K)

 • MEDIUM (30 minutes-4 hours) - Increase renal excretion via a loop diuretic (give with fluids if volume depleted or euvolemic) or dialysis

 • SLOW - Bind in the GI tract



- Dr. Ann Marie Kumfer @AnnKumfer



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