Hyperkalemia treatment

Nursing Students General Students

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Nurse friends, when a patient has hyperkalemia we can give Reg insulin IV to push K+ back in the cell and D50 to offset the insulin. Bicarb also can do this too, but we give all three right? What else does the Bicarb do that I'm missing?

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Most will order Calcium Gluconate as well.

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Specializes in critical care.

If a patient is acidotic, the cells will release potassium into the blood, increasing serum potassium levels. Increasing serum pH will encourage potassium to go into the cells, lowering the serum potassium.

Additionally, lactulose will encourage intestinal release of potassium, and albuterol (a beta-2 agonist which can mimic effects of adrenaline) will activate ATPase, which makes the sodium-potassium pumps put potassium in the cell, and sodium out of the cell.

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