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During phlebotomy by venipuncture, fist clenching has commonly been used by the phlebotomists to make veins more prominent. The practice can cause potassium to increase locally so that the serum potassium is increased by as much as 1.6 mmol/L.
Can blood draw cause high potassium?
Often a report of high blood potassium isn’t true hyperkalemia. Instead, it may be caused by the rupture of blood cells in the blood sample during or shortly after the blood draw. The ruptured cells leak their potassium into the sample.
How much is the increase in the potassium level if the fist is repeatedly pumped during venipuncture?
The discrepancies in serum and plasma potassium levels measured at various times in the patient resulted from the methods of phlebotomy used. Both repeated fist clenching and isometric handgrip increased the plasma potassium level by as much as 1.6 mmol per liter in the venous effluent from the contracting arm.
Can potassium be falsely elevated?
Errors in potassium measurement can cause pseudohyperkalemia, where serum potassium is falsely elevated. Usually, these are recognized either by the laboratory or the clinician. However, the same factors that cause pseudohyperkalemia can mask hypokalemia by pushing measured values into the reference interval.
Should you clench your fist during blood draw?
Patients should not be made to tightly clench their fists during phlebotomy procedures because it can cause misleadingly high blood potassium readings, according to a study.
What causes high potassium in blood work?
The leading causes of hyperkalemia are chronic kidney disease, uncontrolled diabetes, dehydration, having had severe bleeding, consuming excessive dietary potassium, and some medications. A doctor will typically diagnose hyperkalemia when levels of potassium are between 5.0–5.5 milliequivalents per liter (mEq/l).
What is the main cause of high potassium?
The most common cause of high potassium is kidney disease. Other causes of high potassium include: Dehydration. Some medicines.
What is clenched fist syndrome?
Background. The Clenched Fist Syndrome (CFS) is a type of a psychiatric disorder, in which the patients show flexion finger contractures. Although no organic etiology can be identified, the syndrome in most cases presents with pain and paradoxical stiffness.
Does clenching fist raise blood pressure?
No systematic effect (lower or higher blood pressure) from making a fist was observed, but individual effects were often marked, as evidenced by the median absolute differences (regardless of ‘+’ or ‘-‘ sign) between the duplicate readings: 5 (range 0-31) versus 3 (0-18) mmHg for systolic blood pressure, and 4 (0-22).
What happens if blood is drawn too quickly?
Unsafe phlebotomy can cause adverse effects for patients; such effects are rare, but range from pain or bruising at the site of puncture, to fainting, nerve damage and haematoma.
How do you flush excess potassium?
This may include: Water pills (diuretics) help rid your body of extra potassium. They work by making your kidney create more urine. Potassium is normally removed through urine. Potassium binders often come in the form of a powder. They are mixed with a small amount of water and taken with food.
What are signs that your potassium is high?
What are the symptoms of hyperkalemia (high potassium)? Abdominal (belly) pain and diarrhea. Chest pain. Heart palpitations or arrhythmia (irregular, fast or fluttering heartbeat). Muscle weakness or numbness in limbs. Nausea and vomiting.
Can Hemolyzed blood cause high potassium?
Of all routine blood tests plasma/serum potassium measurement is one of the most sensitive to the effect of hemolysis because red-cell potassium concentration is so much higher than that of plasma (approximately 20 times higher); hemolysis causes a spuriously high plasma potassium concentration.
When performing a capillary puncture you should?
Hold the finger in an upward position and lance the palm-side surface of the finger with proper-size lancet (adult/child). Press firmly on the finger when making the puncture. Doing so will help you to obtain the amount of blood you need. Cap the Microtainer® and gently invert it 10 times to prevent clots from forming.
What is the most common phlebotomy site in adults?
The most site for venipuncture is the antecubital fossa located in the anterior elbow at the fold. This area houses three veins: the cephalic, median cubital, and basilic veins (Figure 1).
Why is it hard for me to make a fist?
Tendons are the structures that connect the muscles to the bones. When your tendons are injured, performing certain actions such as making a fist can be difficult. We’ve previously looked at problems bending the thumb and problems bending the fingers, and tendon injuries came up a lot in these cases.
When should I be concerned about high potassium levels?
A potassium level higher than 5.5 mmol/L is critically high, and a potassium level over 6 mmol/L can be life-threatening. Small variations in ranges may be possible depending on the laboratory. Whether you have mild or severe hyperkalemia, you should get prompt medical attention to prevent possible complications.
Can drinking a lot of water lower potassium?
Excessive water consumption may lead to depletion of potassium, which is an essential nutrient. This may cause symptoms like leg pain, irritation, chest pain, et al. 6. It may also cause too much urination; when you drink lots of water at once, you tend to urinate frequently.
Which drugs cause high potassium?
Which medications can raise potassium levels? ARBs (angiotensin II receptor blockers). ACE (angiotensin converting enzyme) inhibitors. Spironolactone. NSAIDs (non-steroidal anti-inflammatory drugs). Cyclosporine and tacrolimus. Heparin. Propranolol and labetalol.
Can dehydration cause high potassium?
The body becomes dehydrated when it loses more fluids than it consumes. When the body doesn’t have enough fluids, it can’t process potassium properly, and potassium builds up in the blood, which can lead to hyperkalemia. Symptoms of dehydration include excessive thirst, less frequent urination, and darker urine.
What drugs are potassium binders?
Potassium Binders Kalexate. Kayexalate. Kionex. Lokelma. patiromer. sodium polystyrene sulfonate. sodium zirconium cyclosilicate. SPS.
What does clenched fist syndrome look like?
The clenched fist syndrome is an entity in which the patient keeps one or both hands tightly clenched. It is seen in all groups; hand dominance or compensation is not a factor. It usually follows a minor inciting incident and is associated with swelling, pain, and paradoxical stiffness.
What causes hands to curl inward?
Dupuytren’s contracture is a condition that causes thick, tough tissue to form under the skin of the palm. The thickened, shortened tissue eventually forces some of the fingers to curl inward toward the palm, creating a hand deformity.
Why do I curl my hands when I sleep?
Why does this happen at night? The nerves to the hand pass through tunnels, which become narrower when joints are bent. We tend to sleep in the “fetal position”, with our wrists and elbows in a bent (“flexed”) position.
