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Hypokalemia

  • Criteria

    • K < 3.5
  • Sx

    • AMS, arrhythmia when K < 2.5
  • Labs

    • get a BMP
    • EKG shows U waves, ST depr, QT prolongation
  • Tx

    • if can swallow: KCl PO 20-40 meq/L
    • if can't swallow: IV KCl in D5W
    • replete Mg if hypomagnesemia
  • Ddx

    • intracellular shift
      • alkalosis
      • insulin use
      • albuterol use
    • decreased intake
      • anorexia
      • poor nutrition
    • increased loss
      • GI loss (urine K < 20)
        • vomiting (urine Cl < 15)
        • diarrhea
        • NG suction
        • pancreatitis
        • laxative abuse
      • renal loss (urine K > 20)
        • aldosterone effect
          • dehydration
          • hyperaldosteronism
          • Cushing syndrome
          • renal artery stenosis
          • Liddle's syndrome
        • RTA (metabolic acidosis)
        • Barter syndrome (urine Cl > 15)
        • diuretics
      • sweating
    • other
      • hypomagnesemia

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.