The nurse is assessing a patient who was just admitted to the ICU after a motorcycle accident with multiple crush injuries. His heart rate has fallen to under 60. The EKG shows small P waves, broad QRS waves, and tall T waves. The nurse checks the labs before calling the doctor, but already suspects which abnormality?


•Hyperkalemia >5 mmol/L causes progressing muscle weakness, bradycardia, heart block, and can progress to asystole. Once symptoms begin to show, it is a medical emergency that requires immediate attention.

•EKGs may show small P waves, broad QRS waves, and tall T waves, and a prolonged PR.

•In this patient, the crush injuries likely caused a release of potassium from the cells, leading to hyperkalemia, a condition known as crush syndrome.

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