Bradycardia induced by hyperkalemia.

The incidence of chronic cardiac disease is increasing (Jessup, 2003). As a result, it is important for occupational health nurses to recognize adverse effects (e.g., electrolyte abnormalities, dysrhythmias) associated with current treatment guidelines (Hunt, 2001). As shown in the example in this case study, the current recommended treatment for clients who have myocardial ischemia and left ventricular dysfunction (i.e., ACE inhibitor and a potassium-sparing diuretic) puts clients at risk for hyperkalemia, especially in the presence of renal insufficiency.