Final answer:
To treat hyperkalemia, one must reduce the serum potassium levels, often through stopping potassium intake, shifting potassium intracellularly with insulin and glucose, and enhancing potassium excretion with diuretics. In severe cases, protecting the heart with calcium gluconate and considering dialysis are additional steps. Administering potassium is contraindicated in hyperkalemia.
Step-by-step explanation:
If a patient is hyperkalemic, meaning their potassium levels are higher than the normal range of 3.8-5.0 mEq/L, the treatment approach should be aimed at reducing their serum potassium level and monitoring their cardiac function. It is important to note that administering additional potassium, such as an IV infusion of potassium chloride (KCl), is contraindicated since this would exacerbate hyperkalemia.
Initial treatment steps typically include stopping any ongoing potassium intake, using medications to shift potassium from the extracellular fluid (ECF) back into cells, and enhancing potassium excretion. Insulin with glucose can be administered to promote the shift of potassium into cells. In addition, diuretics may be used to increase the excretion of potassium through the urine, provided the patient's renal function is adequate.
In cases of severe hyperkalemia where there is a risk of cardiac toxicity, measures such as calcium gluconate may be administered to protect the heart, and dialysis may be considered to rapidly remove potassium from the bloodstream. It is critical that treatments are tailored to the underlying cause of hyperkalemia, which could be from conditions like renal failure, dehydration, or Addison's disease.