Fluid and Electrolyte Imbalance: Hypokalemia


  • Potassium plays an important role in nerve conduction, muscle function, acid-base balance and osmotic pressure.
  • Potassium levels are obtained through venous blood extraction.
  • It is a metabolic disorder wherein the level of potassium in the blood is lower than normal (< 3.5 mEq/L).
  • It is associated with shifting of K+ into cells, K+ loss from GI and biliary tracts, renal K+ excretion and reduced K+ intake.
  • It is a result of one of the following:
    • Diarrhea, sweating, vomiting
    • Starvation, malabsorption
    • Bartter’s syndrome
    • Draining wounds
    • Cystic fibrosis
    • Severe burns
    • Primary aldosteronism
    • Chronic alcoholism
    • Osmotic hyperglycemia
    • Respiratory alkalosis
    • Renal tubular acidosis
    • Diuretics, antibiotics and mineralocorticoid administration
    • Barium chloride poisoning


  • Arryrthmias, especially for persons with cardiovascular disease
  • Breakdown of muscle fibers
  • Constipation
  • Fatigue
  • Muscle weakness or spasms, paralysis


  • Correct underlying disorder associated with hypokalemia.
  • Give potassium tablets.
  • Have a diet rich in potassium such as bananas, apples, oranges, milk and tomatoes.

Nursing Considerations:

  1. Record fluid intake and output.
  2. Check blood volume and venous pressure.
  3. Identify ECG changes such as depressed T waves, peaking P waves.
  4. Observe for dehydration. Accurately record state of hydration.
  5. Observe for neuromuscular changes such as fatigue and muscular weakness.

    Photo credits: www.legcrampsite.com

    Daisy Jane Antipuesto RN MN

    Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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