What should I do if hypokalemia suddenly occurs?

Written by Gan Jun
Endocrinology
Updated on December 28, 2024
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Hypokalemia is very common in clinical settings, generally caused by improper diet, insufficient supplementation, or excessive loss. It is recommended that patients first seek further examination at a hospital. If potassium deficiency is confirmed, mild cases can be treated with oral potassium supplements, while moderate to severe cases who experience muscle weakness, flaccid paralysis, and arrhythmias should receive intravenous potassium supplementation in conjunction with oral treatment. It is also important to dynamically monitor electrolyte levels. In daily life, it is important to plan a diet that is rich in vitamins and trace elements, and treat the specific causes of the condition. It is recommended that patients continually monitor their fluid and electrolyte balance, abstain from smoking and limit alcohol consumption, and maintain good daily habits.

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Written by Wei Shi Liang
Intensive Care Unit
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Can people with hypokalemia smoke?

Hypokalemia is not directly related to smoking. However, once hypokalemia occurs, there is definitely an underlying disease. In the case that the primary disease is not controlled, it is advisable to avoid smoking. Potassium is an essential electrolyte for life, and its physiological functions mainly include maintaining cellular metabolism, regulating osmotic pressure, acid-base balance, and maintaining cell stress functions. Once hypokalemia occurs, active treatment should be implemented, primarily addressing the primary disease, symptomatic treatment with potassium supplementation, and avoiding the occurrence of hyperkalemia. The principle of potassium supplementation is that for mild hypokalemia without clinical manifestations, oral potassium should be given; in cases of severe hypokalemia, intravenous potassium supplementation should be administered immediately. Intravenous potassium should ideally not use peripheral veins but establish a central vein, and the speed of potassium supplementation and the monitoring of potassium levels should be controlled.

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Written by Wang Li Bing
Intensive Care Medicine Department
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How is hypokalemia diagnosed?

Hypokalemia refers to a blood potassium level below 3.5mmol/L. Clinically, it is mainly diagnosed through electrolyte tests and arterial blood gas analysis, which can confirm whether a patient has low potassium. After developing hypokalemia, patients may experience symptoms such as fatigue and limb weakness. At this point, treatment should include the oral administration of sustained-release potassium chloride tablets or intravenous infusion of potassium chloride, as well as advising the patient to consume potassium-rich vegetables and fruits to correct hypokalemia. Prolonged hypokalemia can lead to arrhythmia and even endanger the patient’s life. (Medications should be used under the guidance of a clinical doctor, according to the specific situation.)

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Written by Gan Jun
Endocrinology
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What are the symptoms of hypokalemia?

When the body's blood potassium level falls below 3.5 millimoles per liter, it is called hypokalemia. Hypokalemia can cause adverse symptoms in multiple systems of the body, initially causing weakness and fatigue in the limbs, flaccid paralysis, sluggish and absent tendon reflexes, and in severe cases, respiratory difficulty. At the same time, hypokalemia can lead to a series of central nervous system damages, such as apathy, a blank stare, drowsiness, and confusion; it also causes nausea, poor appetite, abdominal distension, and intestinal paralysis among other adverse gastrointestinal phenomena. Additionally, it can lead to palpitations, and rapid atrial or ventricular arrhythmias, among other adverse phenomena. Therefore, it is crucial to provide timely and proper potassium supplementation and correction of blood potassium levels for patients with hypokalemia.

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Written by Wei Shi Liang
Intensive Care Unit
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Hypokalemia is a condition.

Potassium is one of the essential electrolytes for life. Its physiological functions mainly include maintaining cellular metabolism, regulating osmotic pressure, acid-base balance, and maintaining cell stress functions. The human body intakes about 100 millimoles of potassium each day, of which 90% is excreted through the kidneys, and the remainder is excreted through the gastrointestinal tract. Potassium mainly exists inside cells, with serum potassium accounting for only 2% of the total potassium in the body. The concentration of potassium in serum is between 3.5 to 5.5 mmol/L. If the concentration of serum potassium is below 3.5 mmol/L, it is considered hypokalemia, which is often due to insufficient potassium intake or excessive potassium excretion.

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Written by Wei Shi Liang
Intensive Care Unit
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Hypokalemia can cause

Hypokalemia can manifest as weakness, a bitter taste in the mouth, lack of appetite, irritability, or mood swings. In severe cases, symptoms like nausea, vomiting, drowsiness, reduced orientation ability, and confusion may occur. In terms of muscle and nerve effects, hypokalemia leads to decreased neuromuscular excitability, and when blood potassium levels fall below 2.5mmol/L, clinical symptoms of muscle weakness appear. If blood potassium levels drop below 2.0mmol/L, flaccid paralysis and disappearance or weakening of tendon reflexes may occur. In severe cases, paralysis of the respiratory muscles and even respiratory failure might develop. For the gastrointestinal tract, common symptoms include lack of appetite, nausea, and vomiting, with severe cases leading to intestinal paralysis. Hypokalemia can cause an increase in heart rate and even ventricular fibrillation, which can be fatal. Additionally, it can result in metabolic alkalosis. Hypokalemia can cause metabolic alkalosis, and vice versa, with each condition potentially leading to the other, often coexisting simultaneously.