What is the purpose of a physical exam in hyperkalemia (high serum potassium level)?

Updated: Jun 20, 2018
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

In patients with hyperkalemia, vital signs generally are normal. Nonspecific findings can include muscle weakness, fatigue, and depression. Occasionally, cardiac examination may reveal extrasystoles, pauses, or bradycardia resulting from heart block or tachypnea resulting from respiratory muscle weakness. Skeletal muscle weakness and flaccid paralysis may be present, along with depressed or absent deep tendon reflexes. Patients with ileus may have hypoactive or absent bowel sounds.

In general, the results of the physical examination alone do not alert the physician to the diagnosis, except when severe bradycardia is present or muscle tenderness accompanies muscle weakness, suggesting rhabdomyolysis. However, when hyperkalemia has been recognized, evaluation of vital signs is essential for determining hemodynamic stability and identifying the presence of cardiac arrhythmias related to the hyperkalemia. [6]


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