Patient presents with hyperkalemia with no ECG changes. All are used for treatment, EXCEPT:
Prompt treatment is essential for hyperkalemia without ECG changes to prevent cardiac irregularities. It consists of strategies that, Promote potassium redistribution into cells (with glucose, insulin, and beta2-agonist medications) Increase potassium removal (through sodium polystyrene sulfonate, loop diuretics, or hemodialysis). Calcium gluconate administration is indicated when there is ECG changes like arrhythmias. Must know: Hyperkalemia is defined as a serum potassium level >5.5 mmol/L (>5.5 meq/L). Classical ECG manifestations of hyperkalemia: Tall peaked T waves Loss of P waves Widened QRS complex Sine wave pattern Cardiac arrhythmias associated with hyperkalemia include, Sinus bradycardia Sinus arrest Slow idioventricular rythms Ventricular tachycardia Ventricular fibrillation Asystole Ref: Josephson S.A., Samuels M.A. (2012). Chapter e47. Special Issues in Inpatient Neurologic Consultation. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
Glucose + Insulin
Sodium bicarbonate
Calcium gluconate
Resins