Cardic Emergencies: Hyperkalemia (Renal Dialysis/Failure Or Crush Syndrome)

1.

What are some clues that a patient may be suffering from hyperkalemia?

A.

Renal dialysis/failure with poor or non-functioning kidneys
B.

Crush syndrome
C.

Hemodynamically unstable renal dialysis patients or patients suspected of having an elevated potassium with bradycardia and wide QRS complexes.
D.

All of the above

Correct Answer
D. All of the above

Explanation
All of the given clues suggest that a patient may be suffering from hyperkalemia. Renal dialysis/failure with poor or non-functioning kidneys can lead to the accumulation of potassium in the body, causing hyperkalemia. Crush syndrome, which occurs due to prolonged compression of muscles, can also result in the release of potassium into the bloodstream, leading to hyperkalemia. Hemodynamically unstable renal dialysis patients or patients suspected of having an elevated potassium with bradycardia and wide QRS complexes indicate abnormal heart rhythms associated with hyperkalemia. Therefore, all of these clues indicate the possibility of hyperkalemia in a patient.

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2.

The first ALS intervention one should take for patients suffering from hyperkalemia is initiate a IV and treat to appropriate cardiac algorithim.

A.

True
B.

False

Correct Answer
A. True

Explanation
The correct answer is true. When dealing with patients suffering from hyperkalemia, the first ALS (Advanced Life Support) intervention should be to initiate an IV (intravenous) and treat according to the appropriate cardiac algorithm. This is important because hyperkalemia can cause serious cardiac disturbances, including arrhythmias and cardiac arrest. By initiating an IV and following the appropriate algorithm, healthcare providers can administer medications and interventions to stabilize the patient's cardiac rhythm and address the underlying cause of hyperkalemia.

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3.

The following treatment should be considered with medical consultation for adult hyperkalemia patients.

A.

Calcium chloride 0.5-1 grams slow IVP 0ver 3-5 minutes for a max of 1 gram or 10 mL
B.

Sodium bicarbonate 50 mEq IV over 5 minutes
C.

Dextrose 25 grams
D.

Albuterol 20 mg via nebulizer if available
E.

Aspirin 325 mg

Correct Answer(s)
A. Calcium chloride 0.5-1 grams slow IVP 0ver 3-5 minutes for a max of 1 gram or 10 mL
B. Sodium bicarbonate 50 mEq IV over 5 minutes
D. Albuterol 20 mg via nebulizer if available

Explanation
The given answer is correct because it includes the appropriate treatments for adult hyperkalemia patients. Calcium chloride is administered intravenously to stabilize the cardiac membrane and prevent life-threatening arrhythmias. Sodium bicarbonate is given to correct acidosis and shift potassium into cells. Albuterol, if available, is used to stimulate potassium uptake by cells. These treatments help to lower the potassium levels and stabilize the patient's condition.

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4.

With medical consultation, sodium bicarbonate should be given at 50 mEq slow IVP over 5 minutes for hyperkalemic pediatric patients with crush syndrome or functional kidneys.

A.

True
B.

False

Correct Answer
A. True

Explanation
Sodium bicarbonate is recommended to be given at 50 mEq slow IVP over 5 minutes for hyperkalemic pediatric patients with crush syndrome or functional kidneys. This treatment helps in managing the high levels of potassium in the blood, which can be a result of crush syndrome. It is important to administer the medication slowly to avoid any adverse effects. Therefore, the statement is true.

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5.

With medical consultation, sodium bicarbonate should be given at 50 mEq slow IVP over 5 minutes for adult hyperkalemic patients with crush syndrome or functional kidneys with a sodium bicarbonate drip of 100 mEq in 1000mL to run over 30-60 minutes.

A.

True
B.

False

Correct Answer
A. True

Explanation
The given statement is true. In cases of hyperkalemia in adult patients with crush syndrome or functional kidneys, medical consultation recommends administering sodium bicarbonate. It should be given at a rate of 50 mEq slow IVP (intravenous push) over 5 minutes. Additionally, a sodium bicarbonate drip of 100 mEq in 1000mL is advised to be administered over a period of 30-60 minutes. This treatment protocol helps in managing hyperkalemia effectively.

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6.

The following treatment should be considered with medical consultation for pediatric hyperkalemic patients.

A.

Calcium chloride 20 mg/kg (0.2 mL/kg) slow IVP/IO max dose of 1 gram or 10 mL
B.

Oral glucose
C.

Albuterol via nebulizer 2.5 mg for 2 years and older; 1.25 for less than 2 years
D.

Diphenhydramine 50 mg

Correct Answer(s)
A. Calcium chloride 20 mg/kg (0.2 mL/kg) slow IVP/IO max dose of 1 gram or 10 mL
C. Albuterol via nebulizer 2.5 mg for 2 years and older; 1.25 for less than 2 years

Explanation
The correct answer suggests that the treatment for pediatric hyperkalemic patients should include calcium chloride administered at a dose of 20 mg/kg (0.2 mL/kg) slowly through intravenous push or intraosseous route, with a maximum dose of 1 gram or 10 mL. Additionally, albuterol via nebulizer should be given at a dose of 2.5 mg for patients aged 2 years and older, and 1.25 mg for patients under 2 years of age. This treatment plan should be implemented with medical consultation to ensure appropriate management of hyperkalemia in pediatric patients.

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