If the patient is severely bradycardic or manifesting cardiac arrhythmias, appropriate pharmacologic therapy or cardiac pacing should be considered. Direct potassium replacement therapy by the symptomatology and the potassium level. Begin therapy after laboratory confirmation of the diagnosis. If cardiac arrhythmias or significant symptoms are present, then more aggressive therapy is warranted. This treatment is similar to the treatment for severe hypokalemia.
Serum potassium is difficult to replenish if serum magnesium is also low.
Look to replace both. An internist or a nephrologist should be consulted for admission or follow-up care. For patients with mild hypokalemia and minimal symptoms, oral replacement is sufficient. For patients who have severe hypokalemia and are symptomatic, both IV and oral replacement are necessary. Potassium solutions should never be given as an IV push and should be administered as a dilute solution.