WorksheetsHyperkalemia management
Total questions: 10
Worksheet time: 5mins
Normal range of Potassium
3.5- 5.3 mmol/L
3-5 mmol/L
3.1- 5.5 mmol/L
3.5- 5.1 mmol/L
Elevated Potassium level can be detected in ECG changes
Peaked R wave
Peaked T wave
Broad QRS complex
Below are the components for cocktail
IV Calcium gluconate 10% + IV Dextrose 50% 50 mls + Insulin Novorapid 10 units
IV Calcium gluconate 10% + IV Dextrose 50% 50 mls + Insulin Novorapid 50 units
IV Calcium gluconate 20% + IV Dextrose 50% 50 mls + Insulin Novorapid 50 units
If the patient is taking digoxin, the calcium gluconate should be mixed with 100mL 5% glucose and given over 20 minutes. WHY??
as rapid calcium administration may precipitate myocardial digoxin toxicity.
as rapid calcium administration may elevate patient's blood pressure
as rapid calcium administration may elevate K+ levels
Do not give together with sodium bicarbonate or insulin/glucose infusion via the same access site due to the risk of precipitation
False
True
Function of administration of Calcium gluconate
help in protecting the cardiac membrane from harmful cardiac events such as Ventricular Fibrillation
help in bringing down sugar level in blood
help in preventing Atrial Fibrillation
Purpose of administering Insulin
To shift k from extracellular to intracellular
To shift k from intracellular to extracellular
Ensure blood sugar level is monitored at:
• 0 minutes (Before commencing the medication)
• 30 minutes
• 60 minutes
• 120 minutes
True
False
ECG changes in Hyperkalemia
> 9 mmol/L SINE WAVE PATTERN
<4 mmol/L TALL T
6-7 mmol/L ATRIAL STANDSTILL
If you have found a patient with Difficulty in breathing, palpitations or skipped beat, changes in ECG (Peaked T wave), what would be ULTIMATE nursing responsibility?
Administer O2, hook with cardiac monitoring and standby E Trolley.
Inform doctor and prepare for intubation
Obtain medical history from patient and administer on O2
