# Hypokalemia --- **Hypokalemia** is a condition where the concentration of potassium in the [[blood]] is too low. Because we generally find plenty of potassium in our diets, hypokalemia generally only occurs in people who have kidney disease or other medical disorders develop hypokalemia. It can also happen when someone is taking a type of diuretic that also increases the excretion of potassium, or if someone is dehydrated, [[emesis|vomiting]] or having [[diarrhea]]. Natural licorice contains something called *glycyrrhizic acid* (GZA) which actually increases the amount of potassium excreted as waste. However, The kidneys are *much better at retaining sodium than potassium*. This means that it's much easier to be low on potassium, especially if you're on a [[diuretics|loop diuretic]] or [[renin-angiotensin-aldosterone system|aldosterone]] kicks in. Severe hypokalemia can result in fatal changes in [[arrhythmia|heart rhythm]]. Although in general hyperkalemia is much more dangerous than hypokalemia, deaths due to [[dehydration]] or [[eating disorders]] are actually usually a fatal lack of potassium. ### Causes meds especially [[diuretics|loop diuretics]]. also [[corticosteroids]] GI loss alkalosis [[renin-angiotensin-aldosterone system|hyperaldosteronism]] basically the same as corticosteroids [[Cushing syndrome]] increased cortisol triggers ADLO receptors, retaining Na+ and dumping potassium reduced PO intake eating disorder, alcohol use disorder insulin hypersecretion K+ is transported into the cell when the insulin goes in, shifting the balance ## Signs & Symptoms clinical manifestation ECG changes/dysthythmias !!!! Hypoactive reflexes Fatigue • Anorexia N/v • Muscle weakness/cramps V Bowel motility/ileus • Paresthesias ECG changes/dysrhythmias - Flattened T waves - ==Prominent U waves== - ST depression ## Diagnostic Tests labs serum K+ ECG medical interventions RED cardiac monitoring REGULAR frequent status checks carefully IV and PO replacements IV KCl must be infused slooowly you will *never* give K as an IV push, only via pump also a vesicant--kills cells/tissues improved dietary intake ## Treatment Potassium replacement: - IV potassium is a vesicant, very gnarly. - ==Never give it as a IV push== - can stop the heart - Usually we would want to aim for a central line - PO Potassium - ba ## Nursing Considerations nursing interventions full history meds especially diuretics monitor heart changes BUN/Creatinine diet changes educate assess for abd distention, pain, GI bleed hypokalmeia increases the risk that someone will get toxic from digoxin ___