In my new hyperkalemia assessment checklist, one of the first assessment pieces is to look at the last three potassium values. There is an interpretation note on the assessment template that states if hyperkalemia is new triage up. If hyperkalemia is not new, triage down.
Why do I make this recommendation?
As a dietitian, working in a setting where patients are seen multiple times, there is a higher chance that someone who has had hyperkalemia in the past has received some low potassium diet teaching. However, for someone who is hyperkalemia naive, the chances of this is much lower.
However, there is actually more here than my assumption your patient has previously had low potassium diet teaching.
Chronic vs acute hyperkalemia
According to the authors of this review, evidence suggests that those who are experiencing rapid rises in their serum potassium levels are more likely to experience an adverse event than those experiencing a slow, steady rise over time.
So, not only are those folks who have had hyperkalemia for the past 6 months more likely to have received diet teaching, they may also be less likely to experience a negative outcome from their potassium.
However, those who are experiencing rapid increases in potassium, or if this is their first occurrence may be more likely to experience an adverse outcome and may have been less likely to have previous diet teaching.
Take Aways
When there are more referrals than minutes in a day and you have to make decisions on who to see first. Keep in mind, when it comes to hyperkalemia:
- Mildly elevated and stable – triage down
- New onset hyperkalemia or rapid increase – triage up
Of course, once the triaging is down, the real fun begins. So stayed tuned to my hyperkalemia assessment series and check out my new hyperkalemia assessment templates by signing up here.
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