Which symptom is an early indication that the clients serum potassium level is below normal?
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Topic Resources In hypokalemia, the level of potassium in blood is too low. A low potassium level has many causes but usually results from vomiting, diarrhea, adrenal gland disorders, or use of diuretics. A low potassium level can make muscles feel weak, cramp, twitch, or even become paralyzed, and abnormal heart rhythms may develop. The diagnosis is based on blood tests to measure the potassium level. Usually, eating foods rich in potassium or taking potassium supplements by mouth is all that is needed.
Typically, the potassium level becomes low because too much is lost from the digestive tract due to vomiting, diarrhea, or excessive laxative use. Sometimes too much potassium is excreted in urine, usually because of drugs that cause the kidneys to excrete excess sodium, water, and potassium (diuretics). Certain drugs (such as insulin, albuterol, and terbutaline) cause more potassium to move from blood into cells and can result in hypokalemia. However, these drugs usually cause temporary hypokalemia, unless another condition is also causing potassium to be lost. Hypokalemia is rarely caused by consuming too little potassium because many foods (such as beans, dark leafy greens, potatoes, fish, and bananas) contain potassium.  A slight decrease in the potassium level in blood usually causes no symptoms. A larger decrease can cause muscle weakness, cramping, twitches, and even paralysis. If hypokalemia lasts for an extended time, kidney problems may develop, causing the person to urinate frequently and drink large amounts of water.
The diagnosis is made by measuring a low potassium level in the blood. Doctors then try to identify what is causing the potassium level to decrease. The cause may be clear based on the person’s symptoms (such as vomiting) or use of drugs or other substances. If the cause is not clear, doctors measure how much potassium is excreted in urine to determine whether excess excretion is the cause.
If a disorder is causing hypokalemia, it is treated. Usually, potassium can be replaced by taking potassium supplements by mouth. Because potassium can irritate the digestive tract, supplements should be taken in small doses with food several times a day rather than in a single large dose. Special types of potassium supplements, such as wax-impregnated or microencapsulated potassium chloride, are much less likely to irritate the digestive tract. To treat hypokalemia more rapidly, potassium is given by vein (intravenously) in the following situations:
Most people who take diuretics do not need to take potassium supplements. Nevertheless, doctors periodically check the potassium level in blood so that supplements can be given if necessary. Alternatively, diuretics that help the kidneys conserve potassium (potassium-sparing diuretics), such as amiloride, eplerenone, spironolactone, or triamterene can be used, but these drugs are used only if the kidneys are functioning normally. CLICK HERE FOR THE PROFESSIONAL VERSION Copyright © 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved. Potassium is an electrolyte that is key to nerve and muscle function, blood pressure, and fluid balance. Abnormal levels can be a sign of underlying health issues. Learn about the causes and effects of low and high potassium levels. and what you can do to improve them. What is Potassium?Potassium in The Human BodyPotassium is an essential mineral and positive ion that has many important functions in our bodies. Potassium [1, 2, 3]:
The majority of the body’s potassium is located inside the cells, where it is involved in the production of proteins, helps maintain water balance, plays a role in cell division and accelerates chemical reactions [4, 5]. The largest storage of potassium in the human body is in the muscles [1]. The blood levels of potassium, called serum potassium in medical literature, amount to only about 2% of the total body potassium [1]. Potassium is absorbed through the gut and removed by the kidneys through urine [1, 6]. Testing potassium is important for evaluating kidney, heart, and adrenal health. Normal RangeThe normal range is around 3.5- 5.3 mmol/L. It can vary slightly between laboratories. Even minor departures from the normal range are associated with significant negative effects [7]. Several factors contribute to variations in serum potassium levels. A study showed that serum potassium was lowest in the evening (around 9 p.m.) and highest in the early afternoon (1 – 3 p.m.) [8]. Average ranges of serum potassium can vary for people in different geographic locations, likely as a result of dietary differences [9]. One study has found that men in China have lower serum potassium levels than averages in other parts of the world [9]. In the United States, serum potassium concentrations tend to be lower in African Americans than in people of European ancestry [10]. During pregnancy, it is normal that potassium levels are higher because the kidneys eliminate less potassium; increases in the hormone progesterone could be responsible for adapting the body to this change. Low Potassium LevelsLow potassium is known as “hypokalemia” (hypo = low, kalemia = blood potassium). A result that’s lower than normal, doesn’t necessarily mean that you have a health condition needing treatment. Your doctor will interpret your result, taking into account your medical history, symptoms, and other test results. CausesCauses shown below are commonly associated with low potassium levels. Work with your doctor or another health care professional to get an accurate diagnosis. Factors that can decrease potassium include:
Serum potassium in healthy people does not vary significantly with dietary potassium or the amount of potassium stored in the body [3]. As a result, poor potassium intake is often not the true cause of hypokalemia. However, people with extremely poor diets and people on severe weight-reduction programs are in danger of developing severe potassium deficiency [24, 25, 7, 26]. Some drugs can also decrease potassium levels, including:
SymptomsSymptoms of low potassium include [11, 27, 31]:
Why is Low Serum Potassium Bad?Low serum potassium (hypokalemia) can cause severe disturbances in heart, brain, and muscle function [32]. Increasing PotassiumThe most important thing is to work with your doctor to find out what’s causing your low potassium and to treat any underlying conditions! Discuss the additional strategies listed below with your doctor. None of these strategies should ever be done in place of what your doctor recommends or prescribes! To make sure you have enough potassium:
Studies have found that anxiety increases adrenal hormones, which can decrease blood potassium [17]. Avoid or manage stress. Good strategies to manage stress are getting adequate rest, engaging in exercise, relaxation, meditation, etc. Discuss supplemental potassium with your doctor. This supplement should always be provided under medical supervision due to potential toxicity, especially if you have kidney disease [36, 37]. High Potassium LevelsHigh potassium is called “hyperkalemia” (hyper = high, kalemia = blood potassium). In most people, high potassium can be eliminated or stored away. But in people with certain disorders or diseases, the elimination and storage do not function properly. Also, some drugs can increase potassium above normal. However, a result that’s higher than normal, doesn’t necessarily mean that you have a health condition needing treatment. The result can vary depending on the way your blood sample was taken, for example. Your doctor will interpret your result, taking into account your medical history, symptoms, and other test results. CausesCauses shown below are commonly associated with high potassium levels. Work with your doctor or another health care professional to get an accurate diagnosis. High potassium can be caused by:
The following drugs can increase potassium levels:
SymptomsHigh potassium levels are often without symptoms. Alternatively, a person can experience [40, 47]:
Why is High Serum Potassium Bad?Left unaddressed, moderate to severely elevated serum potassium (hyperkalemia) can lead disturb the heart rhythm, which can be fatal [40]. Extremely high serum potassium should thus be handled as an emergency, and monitoring levels of those at risk is essential [40]. Older patients, patients with chronic heart failure, kidney failure, and diabetic patients are prone to developing hyperkalemia [48]. Decreasing PotassiumThe most important thing is to work with your doctor to find out what’s causing your high potassium and to treat any underlying conditions. Make sure you are well hydrated [38]. Dehydration can increase blood potassium. Avoid salt substitutes and packaged foods that contain them, as they usually contain potassium. If your kidney function is impaired, you may need to go on a low potassium diet. What symptoms would indicate low serum potassium?Common signs and symptoms of potassium deficiency include weakness and fatigue, muscle cramps, muscle aches and stiffness, tingles and numbness, heart palpitations, breathing difficulties, digestive symptoms, and changes in blood pressure.
When serum potassium level is below normal its called?If you have hypokalemia, that means you have low levels of potassium in your blood. Potassium is a mineral your body needs to work normally. It helps muscles to move, cells to get the nutrients they need, and nerves to send their signals. It's especially important for cells in your heart.
Why would serum potassium be low?Low potassium (hypokalemia) has many causes. The most common cause is excessive potassium loss in urine due to prescription medications that increase urination. Also known as water pills or diuretics, these types of medications are often prescribed for people who have high blood pressure or heart disease.
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