Fluid & Electrolytes Nursing Students Hyperkalemia Made Easy NCLEX Review

Summary

In this educational video, Sarah from registernurseRN.com discusses hyperkalemia, a condition characterized by high levels of potassium in the blood. She contrasts it with hypokalemia, covered in a previous video, and emphasizes the importance of understanding both for nursing exams. Sarah breaks down the term 'hyperkalemia', explains the normal potassium range, and outlines the dangers of levels exceeding 7. She delves into the cellular mechanics, causes, symptoms, and treatment options, including the use of K exelate and hypertonic glucose with insulin. The video concludes with a recommendation to take a quiz on the website for further practice.

Takeaways

• 😀 Hyperkalemia refers to a high level of potassium in the blood, with normal levels being 3.5 to 5.1 mmol/L and levels above 7 mmol/L being dangerous.
• 🔬 The term 'hyperkalemia' can be broken down into 'hyper' meaning excess or high, 'kal' from 'potassium,' and 'emia' indicating blood, thus meaning high potassium in the blood.
• 🌐 Potassium is primarily found inside cells (intracellular), but in hyperkalemia, it shifts to the outside (extracellular), affecting blood test results.
• 🏥 Causes of hyperkalemia include cellular shift, adrenal insufficiency, renal failure, excessive potassium intake, and certain drugs like potassium-sparing diuretics and ACE inhibitors.
• 🏃‍♂️ Signs and symptoms of hyperkalemia include muscle weakness, decreased urine output, respiratory failure, decreased cardiac contractility, muscle twitching and cramps, profound weakness, and rhythm changes on EKG.
• 📊 EKG changes in hyperkalemia include tall, peaked T-waves, flat or absent P-waves, wide QRS complexes, prolonged PR interval, and potentially life-threatening cardiac arrhythmias.
• 🛑 Interventions for hyperkalemia involve monitoring cardiac, respiratory, neuro, muscular, and GI status, stopping IV potassium infusions, initiating a potassium-restrictive diet, and preparing the patient for possible dialysis.
• 🥗 Foods high in potassium, which should be restricted in hyperkalemia, include potatoes, pork, oranges, tomatoes, avocados, strawberries, spinach, fish, mushrooms, muskmelon, carrots, raisins, and bananas.
• 💊 Medications that may be used to treat hyperkalemia include K-exelate (sodium polystyrene sulfonate), Lasix (furosemide), and insulin with glucose to drive potassium back into cells.

Q & A

What is hyperkalemia?

Hyperkalemia refers to a condition where there is an abnormally high concentration of potassium in the blood. It is characterized by a potassium level higher than the normal range of 3.5 to 5.1 mmol/L, with levels above 7 mmol/L being considered dangerous.

What are the normal potassium levels in the blood?

The normal potassium levels in the blood are typically between 3.5 to 5.1 mmol/L, although some sources may vary slightly and consider the range to be 3.4 to 5.2 mmol/L.

How does potassium move from intracellular to extracellular fluid in hyperkalemia?

In hyperkalemia, potassium shifts from the intracellular fluid to the extracellular fluid due to factors such as tissue damage, burns, or acidosis, leading to an increased concentration of potassium in the blood.

What are the causes of hyperkalemia as described in the video?

The causes of hyperkalemia include cellular movement of potassium, adrenal insufficiency, renal failure, excessive potassium intake, and certain drugs such as potassium-sparing diuretics, ACE inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs).

What is the significance of the acronym 'CARED' in relation to hyperkalemia?

The acronym 'CARED' is used to remember the causes of hyperkalemia: Cellular movement, Adrenal insufficiency, Renal failure, Excessive intake, and Drugs.

What are the clinical signs and symptoms of hyperkalemia?

Clinical signs and symptoms of hyperkalemia include muscle weakness, decreased or absent urine production, respiratory failure, decreased cardiac contractility, muscle twitching and cramps, profound weakness, and rhythm changes on an EKG.

What does the word 'MURDER' help remember in the context of hyperkalemia?

The word 'MURDER' is a mnemonic to remember the signs and symptoms of hyperkalemia: Muscle weakness, Urine output issues, Respiratory failure, Decrease in cardiac contractility, Early muscle twitching, Late profound weakness, and Rhythm changes.

What are the key differences in an EKG reading for a patient with hyperkalemia?

In hyperkalemia, EKG changes include tall, peaked T-waves, flat or absent P-waves, wide QRS complexes, prolonged PR interval, and potentially cardiac arrest rhythms like ventricular fibrillation or tachycardia.

What interventions are recommended for a patient with hyperkalemia?

Interventions for hyperkalemia include monitoring cardiac, respiratory, neuromuscular, and GI status, stopping IV potassium infusions or oral supplements, initiating a potassium-restrictive diet, preparing the patient for possible dialysis, administering K exelate, using potassium-wasting drugs like Lasix, and administering hypertonic glucose and insulin to shift potassium back into cells.

How can one remember which foods are high in potassium?

A mnemonic to remember foods high in potassium is 'POTAS': Potatoes, Pork, Oranges, Tomatoes, Avocados, Spinach, Strawberries, Fish, Mushrooms, Muskmelon, Carrots, Raisins, and Bananas.