Hyperkalemia: The Daily PANCE Blueprint
Which of the following is the earliest EKG change seen in hyperkalemia?
A. U wave
B. QRS widening
C. Sine-wave pattern
D. Peaked T waves
E. Loss of P wave
Answer and topic summary
The answer is D. Peaked T waves
Hyperkalemia is caused by many things: medications (ACEI/ARBs, beta blockers, NSAIDS), cellular destruction (hemolysis, tumor lysis syndrome, burns), renal failure, adrenal insufficiency, acidosis, etc. Symptoms are nonspecific and include muscle weakness, nausea and vomiting (N/V), decreased deep tendon reflexes (DTRs), and muscle cramps. Classically, on EKG, you may find peaked T waves (there are many other EKG findings, though, such as QRS widening, PR interval prolongation, loss of P wave, and sine-wave pattern). Management for severe hyperkalemia includes calcium gluconate (stabilizes the resting membrane potential of myocardial membrane), shifting potassium intracellularly (via beta agonists, sodium bicarbonate, insulin) or removing potassium (via diuretics, kayexalate or hemodialysis).
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Renal System ⇒ ⇒
