A nurse is caring for a patient with hyperkalemia. The nurse knows that the most likely complication of this condition is:

Appeared in: NORCET 7 Prelims -2024

Explanation

Hyperkalemia is a medical emergency primarily due to its potential to cause lethal cardiac arrhythmias.
Elevated potassium alters the resting membrane potential of cardiac cells, affecting electrical conduction.
The earliest electrocardiogram (ECG) sign is typically tall, peaked (tented) T waves, reflecting altered ventricular repolarization.
As potassium levels increase, the condition can progress to more severe conduction abnormalities, including widened QRS complexes, loss of P waves, and ultimately ventricular fibrillation or asystole.

Option B: Hyperkalemia does not directly cause increased blood pressure. Severe hyperkalemia can lead to hypotension due to arrhythmias and reduced cardiac output.
Option C: Decreased urine output (oliguria) is a common cause of hyperkalemia, not a complication. The kidneys' inability to excrete potassium leads to its buildup in the blood.
Option D: Acute kidney injury (AKI) is a primary cause of hyperkalemia. When the kidneys are injured, their ability to filter and excrete potassium is impaired, leading to elevated serum levels.

Clinical Relevance

Nursing practice connection: Use the key finding related to Complications of Hyperkalemia to guide bedside assessment, documentation, and the next nursing action.
Nurses must prioritize continuous cardiac monitoring for patients with hyperkalemia to immediately detect and report life-threatening arrhythmias.
Recognizing the classic ECG changes, especially peaked T-waves, is a critical nursing skill for early intervention.
What if? If the patient with hyperkalemia also has hypocalcemia, the cardiotoxic effects of high potassium are significantly worsened, increasing the risk of fatal arrhythmias even at lower potassium levels. This makes prompt calcium administration even more critical.

How to Approach the Question

First, identify the core concept of the question, which is hyperkalemia.
Next, focus on the specific keyword in the question: 'complication'. This requires you to differentiate between causes, signs/symptoms, and consequences of the condition.
Evaluate each option to determine if it is a cause or a complication of hyperkalemia.
Option A describes cardiac effects, which are a direct result of high potassium levels on heart muscle.
Options C and D (decreased urine output and AKI) are well-known causes of hyperkalemia, as impaired kidney function prevents potassium excretion.
Option B (increased blood pressure) is not a typical finding; severe hyperkalemia often leads to hypotension.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 542-544

E6 Gynecology Williams p. 64-85

Practise the full NORCET 7 Prelims -2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.