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Management of Hypokalemia



- Signs & Symptoms
- Potassium Supp
- Diff Dx 

- Management:
     - hypokalemia assoc w Met Alkalosis is treated w/ Chloride;
     - Moderate Hypokalemia: (Serum K+ < 3.0 mmol/L) 
             - may see PAC's but no (or infrequent) PVC's & no digoxin toxicity;
     - potassium supplementation: 
             - Slow K = 8 mmol KCl; 
             - Kay Ciel Elixer = 20 mmol/15 ml; 
             - K-Lyte = 25 mmol/packet; 
             - IV replacement therapy in this situation is reserved for patients w/ marked hypoK or pts who are unable to take oral supplements;
     - w/ Severe Hypokalemia: < 3.0; 
             - w/ PVC's in the setting of Myocardial ischemia, or with digoxin toxicity;
             - EKG Monitoring
             - IV therapy: - 10 mmol KCl in 100 ml D5W given IV over 1hr x 3; - repeat once or twice as needed;
             - KCl in small volumes is given thru central IV lines, as these high concentrations of potassium are sclerosing to peripheral veins;
             - further maintenance therapy, containing up to 40-60 mmol KCl/L of IV fluid at a maximum rate of 20 mmol/L;
             - KCl may also be given by the administration of liquid salt by NG tube or by PO supplementation;
             - IV < 60mEq/l; 40/hr; or 40mEq KCl PO q6hr x 2-3 doses;
             - 10mEq/100ml D5W; - Recheck serum KCl concentration after each 20-30 mmol IV KCl is given; 

Keep the Metal in Mind

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