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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Last updated: May 5, 2010