SIGNS AND SYMPTOMS OF
HYPOKALEMIA
SYMPTOMS
• Seldom occur unless the plasma K+ conc is <3mmol/L
• Fatigue, myalgia, and muscular weakness of the lower
extremities
• Palpitations; constipation; nausea or vomiting;
abdominal cramping; polyuria, nocturia, or polydipsia;
psychosis, delirium, or hallucinations; depression
• Severe hypokalemia may lead to progressive weakness,
hypoventilation and eventually complete paralysis
• Hypokalemic periodic paralysis
SIGNS
• Signs of ileus
• Hypotension
• Ventricular arrhythmias
• Cardiac arrest
• Bradycardia or tachycardia
• Premature atrial or ventricular beats
• Hypoventilation, respiratory distress
• Respiratory failure
• Lethargy or other mental status changes
• Decreased muscle strength, fasciculations, or tetany
• Decreased tendon reflexes
• Cushingoid appearance (eg, edema)
ADVERSE MEDICAL IMPLICATIONS
OF THIS CONDITION
Hypokalemia
• Impaired muscle metabolism and blunted hyperemic response to exercise
associated with profound K+ depletion increase the risk of rhabdomyolysis
• Smooth muscle function may also be affected and manifest as paralytic ileus
• ECG changes:
– Early changes: T wave flattening or inversion, prominent U wave, ST segment
depression, prolonged QU interval
– Severe K+ depletion: prolonged PR interval, decreased voltage and widening of QRS
complex, and an increased risk of ventricular arrythmias (px with Myocardial Ischemia or
left ventricular hypertrophy)
• Predispose to digitalis toxicity
• Associated with acid-base disturbances related to the underlying disorder
• Intracellular acidification and an increase in net acid excretion or new HCO3-
production: consequence of enhanced proximal HCO3- reabsorption, increased
renal ammoniagenesis, and increased distal H + secretion → generation of
metabolic alkalosis
• Glucose intolerance attributed to either impaired insulin secretion or peripheral
insulin resistance.