Potassium Pete — Hyperkalemia
Peaked T waves, muscle cramps, hold the bananas
Pete eats bananas by the crate and his kidneys quit taking deliveries. Potassium piles up until his ECG grows tall, pointed T waves like warning spikes on a fence.
Pete's K⁺ is above 5.0 and his heart shows it — peaked T waves, widened QRS, bradycardia. Expect muscle cramps, weakness and GI hyperactivity. Stabilize the myocardium with calcium gluconate, shift with insulin plus D50, then remove with kayexalate or dialysis.
Read Potassium Pete's full story →The story arc
The setup
Pete has stage 4 kidney disease, takes lisinopril and spironolactone, and loves salt substitute — which is potassium chloride.
The turn
He notices cramping calves, tingling around his mouth, and legs that feel heavier every day.
The crisis
The monitor shows tall, tented T waves that slide into a widening QRS. His K⁺ is 7.1.
The save
Calcium gluconate goes in first to armor the heart, then insulin with D50 to shift, then dialysis to actually remove it.
NCLEX study section — Hyperkalemia
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Endocrine & Metabolic
Take this chapter into practice questions on the same topic.