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57. In Shift Out - Hyperkalemia

The Intern At Work: Internal Medicine

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In, Shift, Out - How to Manage Hyper-Clemia

Just as homolysis can occur within a patient, it can also occur during or after drawing blood from a patient. clenching, tight tourniquets and mechanical trauma while puncturing a vein are common causes of red cell breakdown that will falsely elevate potassium levels. These labs are often reported as hemolyse samples. So, how does one manage hyper-clemia? Use calcium gluconate to stabilize the heart against life-threatening arrhythmias. As a temporizing measure, shift potassium into cells with 50% dextrose followed by 10 units of intravenous regular insulin. To lower total body potassium stores, administer oral sodium polystyrene sulfonate (K

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