Hypokalem

ia
Clarisse Cloie Lamberte – BSN3D
Table of Contents
01 02 03
About the Risk Factors & Signs and
Disease
Etioloy and pathophysiology
Causes
Predisposing and presipitating
Symptoms
Normal range K+ and causes of
factors K+ loss

04 05 06
Diagnostic Tests Managements Prognosis
Signs and Symptoms Nursing, medical, and surgical Prognosis if treated and
managements untreated
 Background
of the Disease
Hypokalemia is a metabolic imbalance
characterized by extremely low
potassium levels in the blood. It is a
symptom of another disease or
condition, or a side effect of diuretic
drugs.
 Risk Factors

Medications Genetic Alcoholism

Intake of medications such Disorders
Cushing syndrome, Bartter Incidence reportedly as
as laxatives, diuretics, and syndrome, Gitelman syndrome, high as 12.6% (Eleanor
insulin supplements Liddle syndrome, Gullner Lederer, 2021)
syndrome, Glucocorticoid receptor
deficiency.
 Risk Factors

Eating AIDS 
disorders
incidence of 4.6-19.7% in 23.1% of hospitalized
an outpatient setting patients (Eleanor Lederer,
2021).
 Causes
insufficient intake of potassium

excessive losses of potassium in the urine or

through the GI tract
electrolyte imbalances (e.g., 
hypomagnesemia)
 Causes
Intracellular Shift

Secondary losses due to medication

Laxatives (e.g., laxative abuse or bowel
preparation)
Other causes (Bentonite ingestion)
 Key Numbers

< 2.5
< 3.5 mEq/L
Normal K+ level mEq/L
Severe hypokalemia
Potassium (K+) is responsible
for nerve impulse and muscle
contraction
 Symptoms of the Disease
01
Cardiovascu 02
lar of cardiac
● Symptoms Neuromuscular
arrhythmias (e.g.,
● Muscle cramps and spasms
palpitations, irregular
● Muscle weakness, paralysis
pulse, syncope)
● Respiratory failure secondary to
● Hypotension
paralysis of the respiratory
muscles
● Decreased deep tendon reflexes
 Symptoms of the Disease
04
03
Other
Gastrointestin
● manifestations
Hyperglycemia
al vomiting 
● Nausea,
● Polyuria
● Constipation or ileus 
● Symptoms of underlying causes,
● Fatigue
including:
o Dehydration in gastroenteritis
o Tachycardia and tremors in
alcohol withdrawal
o Symptoms of thyrotoxicosis
 Diagnostic Tests
Electrocardiogr
amchanges include flattening and
ECG
inversion of T waves in mild
hypokalemia, followed by Q-T
interval prolongation, visible U wave
and mild ST depression in more severe
hypokalemia
Urine K+
Spot urine – rapid assessment,
Test/s
indicated in urgent cases , less
reliable than 24-hour collections.
24-hr urine collection – less
practical, indicated for chronic
cases and uncertain diagnoses,
more accurate than spot urine.
 Diagnostic Tests
Electrolytes and 
kidney
•
•
function
Serum K  levels 
+

Basic metabolic panel 

• Serum calcium, magnesium, phosphate

Arterial Blood Gas

may show metabolic alkalosis
 Managements
Medical & Surgical Nursing
Pharmacological
Moderate hypokalemia (2.5-2.9 mEq/L)
Generally, hypokalemia • Monitor respiratory rate,
• KCl: Oral or IV repletion may be is a medical, not a depth, and effort.
used. surgical, condition. • Encourage deep breathing &
• Disposition usually determined by coughing exercise.
treatment of underlying disorder. • Monitor heart rate and
Mild hypokalemia with easily reversible cause rhythm.
(3.0-3.5 mEq/L) • Encourage high potassium
• Prioritize treatment of the diet such as bananas, oranges,
underlying condition (e.g., GI fluid tomatoes, etc.
losses).
• Consider oral supplementation.
• Consider increasing dietary
potassium intake
 Managements
Medical & Surgical Nursing
Pharmacological
Severe hypokalemia (< 2.5 mEq/L)
Generally, hypokalemia • Assess heart rate and blood
and/or high risk of recurrent severe is a medical, not a pressure.
hypokalemia surgical, condition. • Note skin color, temperature,
• KCl: High-dose IV repletion and
• Consider admission to ICU, • moisture
continuous cardiac monitoring, and • Check for any alterations in
central line placement. level conciousness.
• Monitor electrocardiogram
(ECG) for rate, rhythm, and
ectopy.
 Prognosis

Hypokalemia usually resolves with appropriate

therapy. However, in the study by Singer et al of adult
emergency department patients, hyperkalemia and
hypokalemia were implicated as risk factors for death,
relative to their severity. 
 REFERENCES
Al-Momen , A., & El-Mogy , I. (2005). Intragastric balloon for obesity: a retrospective evaluation of tolerance and
efficacy. Medscape drugs & diseases - COMPREHENSIVE peer-reviewed medical Condition, surgery, and
clinical procedure articles with SYMPTOMS, Diagnosis, STAGING, treatment, drugs and Medications,
prognosis, follow-up, and pictures. https://reference.medscape.com/medline/abstract/15760507.
Eleanor Lederer, M. D. (2021, April 27). Hypokalemia. Practice Essentials, Pathophysiology, Etiology.
https://emedicine.medscape.com/article/242008-overview#a6.
Garth, D. (2020, August 31). What is the prognosis of hypokalemia? Latest Medical News, Clinical Trials, Guidelines
- Today on Medscape. https://www.medscape.com/answers/767448-156376/what-is-the-prognosis-of-
hypokalemia.
Hypokalemia. Anmelden bei AMBOSS. (2021, June 30). https://next.amboss.com/us/article/lI0v1h.
Kardalas, E., Paschou, S. A., Anagnostis, P., Muscogiuri, G., Siasos, G., & Vryonidou, A. (2018). Hypokalemia: A
clinical update. Endocrine Connections, 7(4). https://doi.org/10.1530/ec-18-0109
Lederer, E. (2021, April 27). Hypokalemia differential diagnoses. Hypokalemia Differential Diagnoses.
https://emedicine.medscape.com/article/242008-differential.
 
THANK YOU
FOR
LISTENING!