Hyperkalemia — NCLEX Cheat Sheet
K+ > 5.0 mEq/LAlso known as: high potassium · high K · potassium excess
Use this quick-reference guide to spot, treat, and prevent Hyperkalemia on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
⚠️ Causes
- Renal failure = #1 cause
- K-sparing diuretics, ACE, ARBs
- Acidosis, cell lysis, burns
🩺 Signs
- Peaked T waves, wide QRS
- Muscle twitch → flaccid paralysis
- ↑ bowel sounds, diarrhea
🧪 Meds
- Ca gluconate → protects heart
- Insulin + D50, albuterol shift in
- Kayexalate, dialysis remove K+
🚩 Report
- Cardiac arrest / lethal arrhythmia
- Avoid K+ foods, salt substitutes
📚 Hyperkalemia — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Earliest signs are muscle twitching/cramps progressing to weakness and flaccid paralysis
- ECG changes: tall, peaked T waves, widened QRS, and prolonged PR — can progress to asystole
- GI: hyperactive bowel sounds, diarrhea, abdominal cramping
- Renal failure is the most common cause
Nursing priorities
What to do, in order- Cardiac monitor — peaked T waves signal emergent risk
- Calcium gluconate IV to stabilize the myocardium (does not lower K⁺)
- Shift K⁺ into cells: IV insulin with dextrose, and/or nebulized albuterol, sodium bicarb if acidotic
- Remove K⁺ from the body: sodium polystyrene sulfonate (Kayexalate) or dialysis
- Stop all potassium sources — IV fluids, supplements, K⁺-sparing diuretics
Red flags — report now
Escalate immediately- K⁺ > 6.5 mEq/L or peaked T waves / widening QRS — treat as an emergency
- Hold ACE inhibitors and potassium-sparing diuretics (spironolactone)
Labs & values
Numbers to know- Serum potassium 3.5–5.0 mEq/L (hyperkalemia > 5.0)
Patient teaching
What patients must know- Renal clients: avoid salt substitutes (they are potassium chloride) and high-K⁺ foods
❓ Hyperkalemia: NCLEX FAQs
What are the priority nursing interventions for Hyperkalemia?
Cardiac monitor — peaked T waves signal emergent risk. Calcium gluconate IV to stabilize the myocardium (does not lower K⁺). Shift K⁺ into cells: IV insulin with dextrose, and/or nebulized albuterol, sodium bicarb if acidotic. Remove K⁺ from the body: sodium polystyrene sulfonate (Kayexalate) or dialysis.
What are the warning signs of Hyperkalemia a nurse must report?
K⁺ > 6.5 mEq/L or peaked T waves / widening QRS — treat as an emergency. Hold ACE inhibitors and potassium-sparing diuretics (spironolactone).
What do I need to know about Hyperkalemia for the NCLEX?
Earliest signs are muscle twitching/cramps progressing to weakness and flaccid paralysis. ECG changes: tall, peaked T waves, widened QRS, and prolonged PR — can progress to asystole. GI: hyperactive bowel sounds, diarrhea, abdominal cramping. Renal failure is the most common cause.
What patient teaching is important for Hyperkalemia?
Renal clients: avoid salt substitutes (they are potassium chloride) and high-K⁺ foods.
Quick Tip
Earliest signs are muscle twitching/cramps progressing to weakness and flaccid paralysis.
📖 Related Topics
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