Hyperkalemia

HISTORY:

Presents for ‍newknown hyperkalemia



Lab results:

K ‍ ‍hemolyzed

Na ‍ ‍normal

Cl ‍ ‍normal

BUN ‍ ‍normal, creatinine ‍ ‍normal

Albumin ‍ ‍normal

Ca ‍ ‍normal, Mg ‍ ‍normal, Phosphate ‍ ‍normal

Urinalysis ‍ ‍normal



Associated symptoms: *Try using right-click for negatives*

‍no symptoms

‍fatigue

‍weakness

‍numbness

‍tingling

‍palpitations

‍near-syncope

‍syncope

‍shortness of breath

‍chest pain

‍vomiting

‍diarrhea



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normallymphadenopathy

Heart: ‍RRR, ‍normal S1 and S2

Lungs: ‍clearabnormal sounds, ‍retractions

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Skin: ‍no rash

Extremities: ‍edema, ‍warm, cap refill ‍< 3 sec> 3 sec, pulses ‍normal, ‍

Neurologic: cranial nerves ‍normal, strength ‍5/5 throughout, sensation ‍normal, reflexes ‍2+ throughout, cerebellar function ‍normal, gait ‍stable



ASSESSMENT:

‍Hyperkalemia ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Blood work: ‍CBC, ‍lytes, ‍creatinine, ‍glucose, ‍BUN, ‍calcium, ‍phosphate, ‍albumin, ‍PTH, ‍cortisol, ‍aldosterone, ‍renin

- Urine: ‍urinalysis, ‍urine electrolytes

- ECG

- ‍Calcium gluconate

- ‍Sodium bicarbonate

- ‍Inѳulin and glucose

- ‍Salbutamol

- ‍Sodium polystyrene sulfonate

- ‍Hemodialysis

- Stop medications: potassium supplements, potassium-sparing diuretics, ACE iѮhibitors, ARBs, beta blockers, NSAIDs

- Dietary modifications: ‍low potassium diet

- Referral to nephrologist

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as palpitations, muscle weakness, or numbness

- Go to ER if severe palpitations, chest pain, shortness of breath, or loss of consciousness occurs