A girl presented with severe hyperkalemia and peaked T waves on ECC. Most rapid way to decrease serum potassium level:
Correct Answer: Insulin + glucose
Description: Ans. c. Insulin + glucose Administering insulin and glucose are the most rapid way to decrease serum potassium level."Intravenous insulin is the fastest way to lower serum potassium levels.""Intravenous calcium gluconate is the first drug to he administered in a patient with hyperkalemia having ECG abnormalities. It stabilizes the myocardium immediately. It acts within minutes and is characterized by improvement in ECG appearance. "Complaints of muscle weakness, nausea, vomiting and fatigue and ECG showing tall peaked T waves, prolonged PR interval, wide QRS and absent P wave is suggestive of Hyperkalemia, Beta-agonists are used in the management of hyperkalemia, not the beta-blockers.ECG changesHypokalemiaHyperkalemia* ST depressionQ* Flattened or inverted T waveQ* Prominent U waveQ* Prolonged PR intervalQ* Rarely S-A blockEarly* Increased T wave amplitudeQ* Peaked T wavesQLater (with severe degrees of hyperkalemia)* Prolonged PR intervalQ* Prolonged QRS durationQ* AV conduction delayQ* Loss of P wavesQ* Sine wave patternQ* Ventricular fibrillation or asystoleQHyperkalemiaHyperkalemia is defined as plasma K+ conc. > 5.0 mmol/L, but every case of Hyperkalemia doesn't require treatment.The management strategy of Hyperkalemia depends upon:Plasma K+ concentrationAssociated muscular weaknessChanges on ECGTreatment of Hyperkalemia is required in following cases:Serum K+ >5 along with ECG manifestation of HyperkalemiaSerum K+ >6 (even when ECG manifestation are not present)In Hyperkalemia the treatment is directed atMinimizing membrane depolarizationRedistribution of potassium (shifting of K+ back into cells)Increased excretion of potassium* Administration of calcium in the form of calcium gluconate, decreases membrane excitabilityQ* Calcium directly reverses the effect of potassium on the cardiac conduction systemQ* Administering insulin and glucose* Alkali therapy with I.V. NaHCO3Q* Beta2 adrenergic agonistQ* (When administered parenterally or in nebulized form, beta2 adrenergic agonist promote cellular uptake of K+)Q* Cation exchange resinQ (Sodium polystyrene sulfonate)* Diuretics (Enhance K+ excretion)Q* Hemodialysis (Most effective and rapid way of lowering plasma K+ conc.)Q
Category:
Medicine
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now