are the signs of hyper/hypokalemia the same if the cause is a transcellular shift?

[bailyoneohnine]

this is really confusing me! so say someones TOTAL body potassium were to stay the same but they developed BLOOD hyperkalemia due to something like low insulin levels or acidosis. ultimately the intracellular potassium levels would go down leading to the cell being more polarized. would this not be the same though if the TOTAL body potassium was low, leading to the natural movement of potassium out of the cell (again causing the cell to become hyperpoarized)

i'm also confused on potassium's role in blood pressure. I've heard it can cause it to become both high and low, for two reasons that both make sense to me

low BP: low potassium=less excitation=veins can't constrict

high BP: low potassium=high sodium= water diffuses into vasculature

ahh! any insight would be greatly appreciated!!!

[marienm, RN, CCRN]

Yeah, I guess I overstated that. But at initial presentation, serum K+ is often normal to high normal and then will decrease (to below normal) if K+ isn't supplemented during treatment with insulin and fluids. So you'll be often be supplementing someone whose K+ appears to be normal. (Frequent monitoring is key...hope the patient has some good veins!)