Rhabdomyolysis: Nursing Judgment From Muscle Injury to Kidney Protection

Rhabdomyolysis means "dissolution of striated muscle." When skeletal muscle cells rupture, their contents enter the blood. Four of those contents drive nursing priorities: potassium, which threatens cardiac rhythm; myoglobin, which injures renal tubules; phosphate and organic acids, which cause electrolyte and acid-base disturbance; and creatine kinase (CK), the enzyme that confirms and tracks the injury. The condition ranges from a mild, self-limited rise in CK after hard exercise to life-threatening crush syndrome with hyperkalaemic cardiac arrest and dialysis-dependent acute kidney injury (AKI). Because the textbook triad of muscle pain, weakness and dark urine appears in only a minority of clients, the registered nurse identifies risk from the story: an older adult found on the floor, a client pulled from a vehicle, a seizure that would not stop, a worker collapsing in a heat wave, a party drug, or a statin combined with a new antibiotic. Canadian clinical settings report laboratory values in SI units. This lesson uses SI units (for example, creatinine in µmol/L and potassium in mmol/L).