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
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