Hyperkalaemia and Acute Kidney Injury

A child who has had vomiting and diarrhoea may first show fewer wet diapers, tachycardia, delayed capillary refill, and a rising serum creatinine. If potassium rises, the priority can change within minutes: hyperkalaemia may destabilize cardiac conduction even when the initial ECG is not dramatic. Acute kidney injury (AKI) is a pattern of falling kidney function, not a diagnosis by itself. The nurse must recognize the trend, protect airway, breathing, circulation, and cardiac rhythm, determine whether the child is underperfused or fluid overloaded, and escalate for treatment that shifts or removes potassium. The same reasoning applies to an adult, but paediatric assessment must use weight-indexed urine output and weight-based medication orders.