Emergency Nursing Management of Hyperkalemia in Dialysis Patients: Evidence-Based Interventions for Critical Electrolyte Imbalance

Md. Fatin; Happy Akter

Authors

Md. Fatin Department of Biochemistry & Molecular Biology, Tejgaon College, Dhaka, Bangladesh.
Happy Akter Nursing Science, Al Amin Nursing College, Sylhet. Bangladesh

Keywords:

Hyperkalemia, Dialysis patients, Emergency nursing, Electrolyte imbalance, Cardiac arrhythmia

Abstract

Background: Hyperkalemia is a life-threatening electrolyte imbalance commonly seen in dialysis patients due to impaired renal potassium excretion, missed dialysis sessions, dietary factors, and medication effects, leading to severe cardiac complications and increased risk of sudden cardiac arrest if untreated. Aims: To review pathophysiology, risk factors, clinical features, and evidence-based emergency nursing interventions for hyperkalemia in dialysis patients. Methods: This review was conducted using published peer-reviewed articles, clinical guidelines, and nursing literature focusing on hyperkalemia in dialysis patients. Databases including Google Scholar and PubMed were explored to identify relevant studies. Key themes such as pathophysiology, risk factors, clinical manifestations, emergency management, and nursing interventions were analyzed. Evidence from recent studies was synthesized to present updated clinical practices and nursing strategies for effective emergency management of hyperkalemia. Results: Findings indicate that hyperkalemia in dialysis patients is primarily caused by reduced renal potassium excretion, inadequate dialysis, dietary potassium intake, and drug-related factors. Clinically, it presents with neuromuscular weakness, gastrointestinal symptoms, and life-threatening cardiac manifestations such as arrhythmias and ECG changes. Evidence-based nursing interventions include immediate cardiac monitoring, calcium gluconate administration, insulin-glucose therapy, and preparation for hemodialysis. Potassium redistribution therapies provide temporary stabilization, while dialysis offers definitive correction. Early recognition and rapid nursing response significantly reduce mortality and improve patient outcomes in emergency settings. Conclusion: Early nursing intervention, continuous monitoring, and timely dialysis are essential to prevent complications and reduce mortality in hyperkalemia among dialysis patients.

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