Causes of Hyperkalemia can be remembered using the mnemonic MOTHER
- Metabolic acidosis, Medications (ACE-inhibitors, NSAIDS, Beta blockers)
- Overestimated potassium (Pseudo hyperkalemia), Over tissue catabolism, Overdose of digitalis
- Tumor lysis syndrome, Trauma
- Hyperaldosteronism, Hemolysis
- Excessive Intake
- Renal failure, Rhabdomyolysis
Another mnemonic to remember Hyperkaemia causes is MACHINE.
Remember the phrase “The Body CARED too much about Potassium”
Cellular Movement of Potassium from Intracellular to extracellular (burns, tissue damages, acidosis)
Adrenal Insufficiency with Addison’s Disease
Excessive Potassium intake
Drugs (potassium-sparing drugs: spironolactone), Triamterene, ACE inhibitors, NSAIDS)
Signs & Symptoms of Hyperkalemia
Remember the word MURDER
Urine production little or none (renal failure)
Respiratory failure (due to the decreased ability to use breathing muscles or seizures develop)
Decreased cardiac contractility (weak pulse, low blood pressure)
Remember the word POTASSIUM for food rich in potassium.
Musk Melons: cantaloupe
Also included are carrots, cantaloupe, raisins, bananas.
Hyperkalemia management is an important topic, and is frequently asked in exams.
The goal of treatment is to prevent cardiac arrhythmia, then lower serum potassium. The management of hyperkalemia can be summarized by the mnemonic C BIG K DROP.
|Mnemonic||What it means|
|Calcium: Calcium gluconate (10%) 10 mL IV over 10 min . Calcium is a – cardiac stabilizer.|
|B||Beta agonists: Salbutamol 10 – 20 mg in 4 mL normal saline nebulized over 10 min|
– Bicarbonate: sodium bicarbonate 8.4% (50 mEq) 1 ampoule IV over 5 minutes – Both of these agents cause temporary intracellular shift.
|I||insulin: Short acting insulin 10 units IV push followed by … (see next box!)|
|G||Glucose: D50W 1 ampoule IV over 5 minute given with insulin. Insulin causes– temporary intracellular shift and glucose is given to maintain blood glucose levels.|
|K||Kayexalate: Sodium polystyrene sulfonate 15-30 g in 15-30 mL (70% sorbitol) PO. Kayexalate may facilitate– gastrointestinal removal.|
EDITORS NOTE: This is mainly for CHRONIC renal failure. Not for use in the ACUTE phase.
|D||Diuretics: Furosemide 40-80 mg IV push. This facilitates – renal removal.|
“Renal unit for dialysis Of Patient”
|Dialysis achieves extracorporeal removal.|
Again, remember this mnemonic. It will make your life in the wards easy!
The approach to hyperkalemia management can be remembered with the mnemonic
“C BIG K DI” (i.e. if you see a big K, the patient could die!):
C – Calcium gluconate (stabilizes cardiac membrane)
B – Beta-2 agonists (nebulized albuterol) or Bicarbonate (both shift K into cells)
IG – Insulin + Glucose (insulin shifts K into cells + glucose to avoid hypoglycemia)
K – Kayexalate (binds K in gut, excreted in feces lowering total body K stores)
DI – DIuretics (lasix) or DIalysis (if refractory to all other treatment options)
Hope that mnemonic helped. Got a better mnemonic for the same? Let us know in the comments below.
Also check out these medical mnemonics