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HYPOKALEMIA. Andal, Charlotte Ang , Jessy A2. Salient Features. 55 year old, male Diarrhea for several weeks Progressive weakness. Laboratory Findings. Patient. Normal Values. 135-145 meq /L 98-106 meq /L 3.5-5.0meq/L >15 meq /L. Blood Chemistry Na = 140 meq /L

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hypokalemia

HYPOKALEMIA

Andal, Charlotte

Ang, Jessy

A2

salient features
Salient Features
  • 55 year old, male
  • Diarrhea for several weeks
  • Progressive weakness
laboratory findings
Laboratory Findings

Patient

Normal Values

135-145 meq/L

98-106 meq/L

3.5-5.0meq/L

>15 meq/L

Blood Chemistry

  • Na = 140 meq/L
  • Cl= 110 meq/L
  • K = 2.0 meq/L

Urinalysis

  • K = 15 meq/L
slide4
ABG

Patient

Normal Values

7.45-7.45

35-45 mmHg

22-26 meq/L

  • pH = 7.28
  • pCO2= 39mmHg
  • HCO3 = 16 meq/L
1 discuss the diagnostic approach to hypokalemia what is the cause of hypokalemia in this patient

1. Discuss the diagnostic approach to hypokalemia. What is the cause of hypokalemia in this patient?

causes of hypokalemia
Causes of Hypokalemia
  • Decreased intake
    • Starvation
    • Clay ingestion
  • Redistribution into cells
    • Acid-base
    • Hormonal
    • Anabolic state
  • Increased loss
    • Nonrenal
    • Renal
causes of hypokalemia in the patient
Causes of Hypokalemia in the Patient
  • Increased loss
    • Nonrenal
      • Gastrointestinal loss (diarrhea)
      • Integumentary loss (sweat)
    • Renal
      • Increased distal flow
      • Increased secretion of potassium
slide9

Increased renal K excretion

  • Loss of gastric contents  volume depletion and metabolic alkalosis  kaliuresis
  • Hypovolemia stimulates aldosterone release  augments K secretion by the principal cells
  • Filtered load of HCO3 exceeds the reabsorptive capacity of the proximal convoluted tubule  increasing distal delivery of NaHCO3 which enhances electrochemical gradient favoring K loss in the urine
2 what are the signs and symptoms of hypokalemia
2. What are the signs and symptoms of hypokalemia?
  • Fatigue
  • Myalgia
  • Muscular weakness
  • More severe hypokalemia
    • Progressive weakness
    • Hypoventilation
    • Complete paralysis
5 what is the treatment
5. What is the treatment?
  • Therapeutic goals:
    • Correct the K deficit
    • Minimize ongoing losses
slide14

Potassium chloride

    • Preparation of choice
    • Promote more rapid correction of hypokalemia and metabolic alkalosis
  • Potassium bicarbonate and citrate
    • Tends to alkalinize the patient
    • More appropriate for hypokalemia associated with chronic diarrhea