ekg’s & electrolytes steven w. harris mhs, pa-c lock haven university
TRANSCRIPT
HyperkalemiaHyperkalemia
Early EKG Manifestations:T wave: increased amplitude & peaking
Later EKG manifestations:Prolonged PR intervalwidened QRS complexFlattening of the P wave
Causes of HyperkalemiaCauses of Hyperkalemia
Renal failureExcess potassium replacementACE inhibitorsAldosterone antagonistsHypoaldosteronismAcidosis Addison’s Disease
Signs and Symptoms of Signs and Symptoms of HyperkalemiaHyperkalemia
ArrhythmiaCardiac arrestNumbness, tingling, weaknessFlaccid paralysis
Treatment of HyperkalemiaTreatment of Hyperkalemia
Treat underlying cause
Calcium gluconate
Insulin/glucose
Kayexalate
HypokalemiaHypokalemia
T wave flattening or inversion Increased prominence of U waveST segment depressionVentricular ectopySustained tachyarrhythmias
Causes of HypokalemiaCauses of Hypokalemia
Liver cirrhosisVomiting/diarrheaDiureticsCushings or primary Aldosteronism
HypokalemiaHypokalemia
Ventricular arrhythmiasHypotensionCardiac arrestMalaise, muscle weakness, crampsCarpopedal spasm, tetany IleusPolyuria, nocturia, hyperglycemia
Treatment of HypokalemiaTreatment of Hypokalemia
Treat underlying cause
Oral potassium therapy
IV potassium therapy
HypercalcemiaHypercalcemia
QT interval is shortened
ST segment may disappear
PR may become prolonged.
QRS may become prolonged
Causes of HypercalcemiaCauses of Hypercalcemia
MalignancyRenal FailureHyperparathyroidismHyperthyroidismSarcoidosisExcessive Vitamin D ingestion
HypercalcemiaHypercalcemia
AnorexiaNauseaConstipationPolydipsiaPolyuriaLethargy, stupor, comaOrthostasis
Treatment of HypercalcemiaTreatment of Hypercalcemia
Treat underlying cause
Isotonic Saline for volume repletion
Loop diuretics
Causes of HypocalcemiaCauses of Hypocalcemia
HypoparathyroidismVitamin D deficiencyRenal failureHypoalbuminemia Pancreatitis PseudohypoparathyroidismSepsis
HypocalcemiaHypocalcemia
Chvostek’s sign Trouseau’s sign Carpopedal spasm Tetany N/V/D Nervousness, Weakness Paresthesia’s, Stiffness, Muscular cramps,
Headaches