What can cause pseudohyperkalemia?

• A. Hemolysis or clotting during the blood draw
• B. Normal labor symptoms
• C. Intermittent pain with contractions, small amount of blood-tinged mucus 'bloody show'
• D. Placental abruption symptoms

Answer: (A)

Pseudohyperkalemia is a lab artifact where potassium appears elevated in the test result due to the way the specimen is collected or handled, not because the patient actually has high potassium. The most common cause is hemolysis or clotting during blood draw. When red blood cells rupture or clotting occurs in the sample, potassium leaks out of cells into the serum or plasma, falsely raising the measured potassium level.

In practice, if a patient’s ECG or symptoms don’t align with true hyperkalemia, consider a pseudohyperkalemia and repeat the test with proper technique—use a clean draw, minimize tourniquet time, avoid fist clenching, and ensure prompt processing. A hemolyzed sample on the lab report would also point to this artifact.

The other options describe obstetric conditions that don’t cause this lab artifact.