Treating Hyperkalemia

1. Get EKG
2. Ca gluconate- stabilizes cardiac membrane to prevent arrythmias, no effect on K level
3. Albuterol (Beta 2 agonist)- drives K into cell
4. Insulin - drives K into cell: Don't forget to give with Glucose
5. Diuretics- Lasix
6. Kayexalate- GI excretion of K
7. Bicarb- Correct metabolic acidosis
8. Emergent Dialysis

Narcotic Equivalents

Expected Respiratory Compensation In Metabolic Acidosis

WINTER'S FORMULA:

Expected pCO2 = 1.5 *(measured HCO3) + 8 (+/-) 2

Indications for Emergent Dialysis

Acidosis
Electrolytes (K)
Intoxication
Overload
Uremia

Correction of Ca in low Albumin

Corrected Ca= (4-albumin)*0.8+(measured Ca)

Hyponatremia in Cirrhosis

it's dilutional and hormonal (ADH)