Fluid & Electrolyte Q 37

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Vien is receiving oral potassium supplements for his condition. How should the supplements be administered?

  

    A. Undiluted

    B. Diluted

    C. On an empty stomach

    D. At bedtime

    

    

Correct Answer: B. Diluted

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Oral potassium supplements are known to irritate gastrointestinal (GI) mucosa and should be diluted. Mild to moderate hypokalemia is typically treated with oral potassium supplements. Providing 60 to 80 mmol/day in divided doses over days to weeks is usually sufficient. Oral supplementation can irritate GI mucosa leading to bleeding and/or ulceration but is associated with a lower risk of rebound hyperkalemia. It should be taken with plenty of fluids and food.

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Option A: Potassium chloride is the preferred formulation for replacement therapy in most cases. Increasing dietary potassium is not usually adequate to treat hypokalemia because most of the potassium contained in foods is coupled with phosphate.

Option C: The goal of potassium replacement in the context of renal or GI losses is to immediately raise serum potassium concentration to a safe level and then replace the remaining deficit over days to weeks. A potassium-sparing diuretic should also be considered when the etiology of hypokalemia involves renal potassium wasting as potassium replacement therapy alone may not suffice.

Option D: IV administration is preferred in the setting of cardiac dysrhythmias, digitalis toxicity, and recent or ongoing cardiac ischemia. Pain and phlebitis usually occur with peripheral IV infusions when infusion rates exceed 10 mmol per hour.

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