Hypokalaemia

Question 1

What metabolic derangement typically causes potassium depletion ?

Answer 1

Metabolic alkalosis

Question 2

Range for hypokalaemia and life threatening

Answer 2

Less than 3.5 and less than 2.5

Question 3

Categories that cause hypokalemia

Answer 3

1 - excessive losses
2- renal potassium loss
3- redistribution from extra to intra-cellular decongestants
4 - pseudo

Question 4

Main clinical presentation in potassium deficits

Answer 4

A SIC WALT
- alklaosis
- shallow respirations
- irritable
- confusion and drowsiness
- weakness and fatigue
- arrhythmias
- lethargy
- thready pulse
- decreased intestinal motility = nausea, vomiting and ileus

Question 5

What might show on the ECG?

Answer 5

> arrthymmias
flattened Twaves
U waves
ST changes
T wave inversion

** asystole and PEA

Question 6

See pages for ecg

Question 7

What other tests should be done?

Answer 7

U/E , crest, blood gas, urine potassium , CK if rhabdo suspicion,

Question 8

Management steps in hypokalemia

Answer 8

1. ABC
2. Stop all drugs that may be cause or worsen
3. Look for underlying cause
4. Correct any volume deficits - isotonic fluids
5. Parenteral K+ replacement

Question 9

How should potassium replacement be given

Answer 9

Safe replacement rate = 10mmol/hr