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Potassium :banana: (Hyperkalemia (complicated) (cause (Iatrogenic: giving…

- - - - ingestion (diet) w/ CKD
        
        Artifact: hemolysis during blood draw
        
        low aldosterone state: :spades:side effect raises K :banana:
        
        aldosterone antagonist
        
        ARB
        
        ACEi
        
        pt squeezes fist during draw
        
        ESRD simply can't get rid of K+
  - - - peaked T waves
        
        when can't tell diff between QRS & T wave
      - wide QRS
      - possible Heart block
      - Long term uncorrected: Sine wave-(death)
  - - - :green_cross:(-) normal repeat draw
        
        stop :no_entry:
      - :check:(+) another hi K+
        
        EKG shows pattern?
        
        :check:(+) unstable hyperkalemia (EMERGENT) :checkered_flag:
        
        Stabilize
        
        IV Ca2+ :!:
        
        :pencil2:lasts only minutes. reason: stabilizes cardiomyocytes
        
        Temporize
        
        Insulin & D50 :!:
        
        lasts hours
        
        1 more item...
        
        may add Na Bicarb (IV) or ß agonists (nebs)
        
        reduce TBK (total body K)
        
        urine
        
        stool
        
        2 more items...
        
        Loops :roller_coaster::curly_loop::curly_loop:
        
        2 more items...
        
        :green_cross:(-) stable hyperkalemia (urgent)
        
        fix whenever
        
        reduce TBK
- - - - Renal losses
        
        hyper Aldo state
        
        RA stenosis
        
        fibromuscular dysplasia
        
        diuretics: Thiazides and loops
        
        Bartters: Loops & Gitelman: Thiazides
        
        :pencil2: Rx causes are saline responsive
        
        conns
        
        Uworld: ACTH secreting tumors: Cushings disease
        
        :pencil2:Uworld: Saline unresponsive
    - - GI losses
        
        diarrhea
        
        :pencil2:only one thats Met. Acidosis!
        
        vomiting
        
        :pencil2:Uworld: Saline responsive, give isotonic saline
    - - paralysis
      - weakness
  - - - :checkered_flag: very low K, skip to replete
      - recheck labs
        
        :check: repeat low K
        
        EKG
        
        (+) EKG changes :checkered_flag:
        
        Tx: replete K :banana:
        
        rules:
        
        5 more items...