Patients suspected of having severe hypokalemia should be placed on a cardiac monitor, IV access should be obtained, and respiratory status should be assessed. Potassium replacement therapy should be directed by the symptomatology and the potassium level. Therapy should begin 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 dificult to replenish if serum magnesium are 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. IV potassium and oral replacement are necessary. Potassium solutions should never be given as an IV push and should be administered as a dilute solution.