Hypokalemia

First Things First (assess & treat for the following)

• Is the hypokalemia real?
  • Laboratory error: repeat test.
  • Pseudohypokalemia: delayed separation of serum w/ markedly elevated WBC count
• Is pt symptomatic?
  • Severity of signs & symptoms may depend on severity of hypokalemia & rate at which it develops.
  • Most pts are asymptomatic (mild hypokalemia 3.0-3.5 mEq/L).
  • Symptoms of hypokalemia (generally < 3.0 mEq/L): generalized weakness, fatigue, muscle cramps, constipation, polyuria/polydipsia, muscle necrosis (severe), ascending paralysis (severe)
  • Signs of hypokalemia (< 3.0 mEq/L): cardiac arrhythmias, mild glucose intolerance
  • EKG changes: flattened T waves, depressed ST segment, appearance of prominent U waves, prolonged PR interval, widened QRS complex