 Low potassium (hypokalemia) refers to a lower

than normal potassium level in your

bloodstream.
 Potassium is an important electrolyte for nerve
and muscle cell functioning, especially for
muscle cells in the heart. Your kidneys control
your body’s potassium levels, allowing for
excess potassium to leave the body through
urine or sweat.
 A normal level of potassium is 3.6–5.2
millimoles per liter (mmol/L).
 Hypokalemia is divided into the following 3
categories:

 Mild: K+ 3.0-3.5 mEq/L

 Moderate: K+ 2.5-3.0 mEq/L
 Severe: K+ < 2.5 mEq/L
 Your risks for hypokalemia can increase if you:
 take medications, especially diuretics known to
cause potassium loss
 have prolonged illness that causes vomiting or
diarrhea
 S. Electrolytes / Potassium,
 Magnesium, Calcium, Phosphorous,
 TSH (thyroid stimulating hormone)
 Aldosterone,
 ECG,
 Urine Potassium.
 Low potassium (hypokalemia) has many causes. The most common
cause is excessive potassium loss in urine due to prescription
medications that increase urination. Also known as water pills or
diuretics, these types of medications are often prescribed for people
who have high blood pressure or heart disease.

 Vomiting, diarrhea or both also can result in excessive potassium

loss from the digestive tract. Occasionally, low potassium is caused
by not getting enough potassium in your diet.

 Causes of potassium loss include:

 Chronic kidney disease,

 Diabetic ketoacidssis,
 Use of diuretics (Water / Fluid pills),
 Diarrhea / vomiting,
 Excessive sweating due to heat / exercise,
 Excessive use of laxative, enema,
 Excessive laxative use
 Eating disorders (Bulimia)/ low consumption of potassium,
 Magnesium Deficiencies,
 Antibiotics,
 Hyperthyroidism,
 Alcoholism,
 Coughing syndrome,
 Prolonged nasogastric suctioning,
 NPO status,
 Steroids,
 Tissue injury,
 Leukemia,
 Post ileostomy surgery.
 Being aware of hypokalemia symptoms can help. Call your doctor if you are experiencing
these symptoms:
-weakness
-fatigue
-constipation
-muscle cramping
-palpitations
 Levels below 3.6 are considered low, and anything below 2.5 mmol/L is life-threateningly
low. At these levels, there may be signs and symptoms of:
-paralysis
-respiratory failure
-breakdown of muscle tissue
-ileus (lazy bowels)
 In more severe cases, abnormal rhythms may occur. This is most common in people who take
digitalis medications (digoxin) or have irregular heart rhythm conditions such as:
-fibrillation, atrial or ventricular
-tachycardia (heartbeat too fast)
-bradycardia (heartbeat too slow)
-premature heartbeats
 Other symptoms include loss of appetite, nausea, and vomiting.
 monitoring serum potassium levels every 1-3 hours and adjusting
supplement doses as necessary.
 monitor patients on digoxin or those with digoxin toxicity.
 Record fluid intake and output hourly and observe for
dehydration.
 Check vitals sign hourly in critical care unit with severe
Hypokalemia.
 Continue monitoring ECG and Identify ECG changes such as
depressed T waves, peaking P-waves.
 Give mouth care to reduce vomiting tendency.
 Give antiemetic drugs as order.
 Monitor for any complications such as paralysis, cardiac arrest etc.
 Check blood sugar 6 hourly and control by hypoglycemic agent.
 Provide oral potassium diluted in 4-8 oz of water or juice
(decreased gastric mucosa irritation).
 Dilute IV potassium 20-40mEq in 1L of IV fluids and use
infusion pump (irritating to blood vessels and myocardium).
 If central venous line present can be give potassium
supplement through syringe pump 20mEq per hour.
 Be careful that never administer bolus IV potassium.
 Monitor IV site for phlebitis and infiltration if intravenous
cannula present.
 Provide potassium rich diet and consult with dietician.
 Check neurological status hourly by GCS scale.
 Observe for neuromuscular changes such as fatigue and
muscular weakness.
 Teach patient about potassium-rich foods and how to prevent
excessive loss (abuse of laxative and diuretics.
 Provide calm and quite environment so that patient can sleep.
 Give psychological support to reduce anxiety.
 oral potassium chloride is administered when
potassium levels need to be replenished, as well as, in
patients with ongoing potassium loss (eg, those on
thiazide diuretics), when it must be maintained.
Potassium-sparing diuretics are generally used only in
patients with normal renal function who are prone to
significant hypokalemia.

 Angiotensin-converting enzyme (ACE) inhibitors,

which inhibit renal potassium excretion, can ameliorate
some of the hypokalemia that thiazide and loop
diuretics can cause. However, ACE inhibitors can lead
to lethal hyperkalemia in patients with renal
insufficiency who are taking potassium supplements or
potassium-sparing diuretics.
 Eating a diet that is rich in potassium can help prevent and treat low blood
potassium. Discuss your diet with your doctor. You’ll want to avoid
taking too much potassium, especially if you’re taking potassium
supplements. Good sources of potassium include:
 avocados
 bananas
 figs
 kiwi
 oranges
 spinach
 tomatoes
 milk
 peas and beans
 peanut butter
 bran
 While a diet low in potassium is rarely the cause of hypokalemia,
potassium is important for healthy body functions. Unless your doctor
tells you otherwise, eating a diet rich in potassium-containing foods is a
healthy choice.