According to "RN," electrolytes are charged particles found in body fluids that help transmit electrical impulses for proper heart, nerve and muscle function. High levels of the electrolyte potassium, called hyperkalemia, can effect the heart muscle and quickly turn lethal.
History
An imbalance in potassium will alter the electrical equilibrium necessary for normal cell functioning. When potassium levels rise in the bloodstream, a hormone called aldosterone is released, which triggers the kidneys to excrete potassium. When the kidneys are not functioning properly, this does not happen and potassium levels rise. High levels of potassium causes increased activity of cells.
Significance
According to "Fluids and Electrolytes DeMystified," the normal range of potassium is between 3.5 to 5.0 mEq/L. Levels above 5.0 mEq/L require immediate treatment. Hyperkalemia can be caused by increased oral or intravenous intake, kidney disease or the use of diuretic medications. Diuretic are medications that enhance urine output. Patients who have severe burns, crush injuries or have undergone major surgery are at a higher risk of developing hyperkalemia because the integrity of the cell membrane has been disrupted. Kidney disease is the most common reason for hyperkalemia.
Symptoms
As the levels of potassium elevate, patients will have restlessness, abdominal cramping and a lack of energy. Muscle weakness occurs effecting the respiratory system, which causes paralysis of the lungs leading to respiratory failure. Hyperkalemia effects the heart muscle and eventually slows the conduction of electrical impulses that can lead to cardiac arrest.
Treatment
Calcium chloride or calcium gluconate are the most rapid antidotes for used for treating hyperkalemia. These medications are given intravenously. Potassium can also be reduced by giving glucose, insulin and sodium bicarbonate. These substances will shift potassium out of the bloodstream and into the cells. The use of diuretics may be beneficial to help excrete potassium with urine output. If all of these efforts fail, patients may require dialysis.
Diagnoses
Hyperkalemia is diagnosed by monitoring potassium levels through blood tests. Hyperkalemia is normally responsive to treatment, but mortality with unrecognized hyperkalemia is high as a consequence of the cardiac or respiratory arrest.
References
- "RN"; Restoring Electrolytes; Astle; May 2005
- "Fluids and Electrolytes DeMystified"; McGraw Hill; 2008
- "Sheehy's Emergency Nursing Principles and Practice"; Mosby Elsevier: 2010
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