Twenty-four hours after colon resection, urine output in a 70-year-old man is 10 mL/h.
Blood chemistry analysis reveals sodium, 138 mEq/L; potassium, 6 mEq/L; chloride, 100 mEq/L; bicarbonate, 14 mEq/L.
His metabolic abnormality is characterized by which of the following?
(A) Abdominal distension
(B) Peaked T waves
(C) Narrow QRS complex
(D) Cardiac arrest in systole
(E) J wave or Osborne wave
Answer:
(B) Peaked T waves
Discussion: Hyperkalemia can manifest by GI or cardiovascular signs. GI symptoms include nausea, vomiting, intestinal colic, and diarrhea. Abdominal distension as a result of paralytic ileus is due to hypokalemia. An ECG is useful to monitor potassium levels. Hyperkalemia is characterized by peaked T waves. ECG changes also include ST-segment depression, widened QRS complex, and heart block. Cardiac arrest occurs in diastole with increasing levels of potassium.
Osborne (J) wave is seen in hypothermia.
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