Hypokalemia resident survival guide: Difference between revisions

Jump to navigation Jump to search
Line 33: Line 33:


3) For severe hypokalemia (K < 2.5 mEq/L)
3) For severe hypokalemia (K < 2.5 mEq/L)
a) EKG findings show 'U' wave, flat or inverted T waves.
* EKG findings show 'U' wave, flat or inverted T waves.
b) Intravenous KCL 80 mEQ/L @ 10-15mEq/hr with oral KCL 40-80mEq/L
* Intravenous KCL 80 mEQ/L @ 10-15mEq/hr with oral KCL 40-80mEq/L
c) Recheck potassium levels in 2-4 hours
* Recheck potassium levels in 2-4 hours


==Do's==
==Do's==

Revision as of 13:31, 22 November 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Definition

Hypokalemia is defined as plasma potassium levels less than 3.5 mEq/L

Causes

Life Threatening Causes

Life-threatening conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

 
 
 
 
 
 
 
 
Potassium < 3.5 mEq/L
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Increased urinary loss
measure spot urine potassium
 
Redistribution defects
Elevated glucose
Insulin excess
alkalosis
Periodic paralysis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Spot Urine K < 10
GI losses
Biliary losses
Laxative abuse
Intestinal fistula
 
 
 
 
 
 
Spot urine K > 20
Renal causes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Elevated BP
High Aldosterone
 
 
 
 
 
Normal BP
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Plasma renin
 
 
 
 
 
Plasma bicarbonate
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Low Renin
Primary Hyperaldosteronism
 
High Renin
Secondary Hyperaldosteronism
 
Low Bicarbonate
RTA 1
RTA 2
 
Low Bicarbonate
measure urine chloride
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Metabolic alkalosis
Vomiting
 
Diuretics
Bartters syndrome

Management

1) Hypokalemia may present as ileus, muscle cramps, rhabdomyolysis, and hypomagnesemia.

2) Treat the etiology.

3) For severe hypokalemia (K < 2.5 mEq/L)

  • EKG findings show 'U' wave, flat or inverted T waves.
  • Intravenous KCL 80 mEQ/L @ 10-15mEq/hr with oral KCL 40-80mEq/L
  • Recheck potassium levels in 2-4 hours

Do's

Dont's

References