What is patients cardiac rhythm Are ECG changes present

Hyperkalemia can produce lethal cardiac rhythm disturbances. Recognition of peaked T waves, PR prolongation, or widened QRS complex requires immediate action. Serum potassium level may be rapidly lowered by IV administration of bicarbonate or insulin (and glucose), or both.

B. Is potassium in any form being administered? If so, has that been stopped? Unrecognized sources of potassium include IV fluids and blood products. Check that patient's actual fluid matches the appropriate order.

C. What has urine output been over the past several hours? Hyperkalemia may be a manifestation of decreased glomerular filtration rate (GFR) and may be a herald of renal failure. Continuing administration of potassium in this setting can be quite dangerous.

D. Is laboratory result accurate? Any hemolysis or cell lysis of a blood sample may increase potassium within the sample but may not be a true reflection of serum potassium level. Obtaining blood from a large-bore vein or an arterial sample may decrease the likelihood of hemolysis.

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