What is the lowest K+ level you have seen?

[nlhnurse1982]

So I was just wondering what the lowest potassium level was that any of you out there have seen and was the patient symptomatic ad how did the doc treat it? I had a pt come in the other night who was 1.7 due to diarrhea over the past 3 months. She had a 40meq rider over 5hrs in the ED it brought her up to a whopping 1.8 and the physician only ordered another 10meq to go over an hour and a recheck the next morning (this seemed to be conservative to me). She was made npo and ordered maintence IVF of NS at 80cc/hr no K+ was added to the IVF. The pt had a normal EKG and was not symptomatic thankfully!

[zenman]

So I was just wondering what the lowest potassium level was that any of you out there have seen and was the patient symptomatic ad how did the doc treat it? I had a pt come in the other night who was 1.7 due to diarrhea over the past 3 months. She had a 40meq rider over 5hrs in the ED it brought her up to a whopping 1.8 and the physician only ordered another 10meq to go over an hour and a recheck the next morning (this seemed to be conservative to me). She was made npo and ordered maintence IVF of NS at 80cc/hr no K+ was added to the IVF. The pt had a normal EKG and was not symptomatic thankfully!

If she was not symptomatic, I wouldn't slam her up to normal either. Can't remember any as low as 1.7 but had one up to 9 due to some vitamin supplement that was high in K+.

[PAERRN20]

I bet the doc didn't want to overload her. Going from 1.7 to even a 3.5 is almost doubling the amount of potassium. If she's lived at 1.7 for 3 months she can likely live at it for a day or so longer.

I haven't seen anything low as 1.7 but I did have an 8.7 the other day.

[Lacie, BSN, RN]

I've see at the lowest 1.5 ekkk!!! But on another note when I first started working in chronic dialysis I would freak out as a former CTU/CCU nurse when I had a lab come back on a pt with a K level of 6.9. Nephrologist would just respond "Cant help what he puts in his mouth, get a nutritional consult". He wouldnt change the bath either. Usually after some stern lectures about diet their next draw would be down to an acceptable level. I have one young lady I cant get hers above 2.5 and she eats everything under the sun with K to get it back up. If you supplement her she spikes to high. But then again dialysis pts can tolerate K spikes more so then non renal pts.

[Dalzac, LPN, LVN, RN]

I once had a frequent flyer paint huffer who would come in with a K of 1.2. She couldn't move any of her muscles and would be paralyzed until her K came up to 2.3 When her K would be in a normal level and she could move on her own she would go AMA. I heard she died from liver failure a a few years ago.

[cardiacmadeline, RN]

I don't remember the lowest K+ I've ever seen, I don't recall seeing any under 2. Now the highest K+ I've seen is 11! It was a couple of years ago and it wasn't my patient so I don't remember what was going on with the patient.

[esrun00]

The lowest I have seen was a 1.2. The patient was being transferred to our hospital with anemia, thrombocytopenia and hypokalemia. Turns out they had AML. The transferring hospital gave her an oral dose of potassium. Leukemics do usually have low potassium levels, just like all the other levels.

kt

[VICEDRN, BSN, RN]

HIV/AIDS patient: 1.9

But I knew you guys would beat me!

[Purple_Scrubs, BSN, RN]

I had a pt once who was 1.1 on arrival, but it was up in the high 2's by the time I had him. He was very disoriented on admit but was awake and talking! Could not believe that one.

[emtb2rn, BSN, RN, EMT-B]

Last night. 50 y/o F, k=1.5, na=107. Hx anorexia, in for medical clearance. AAOx3, totally asymptomatic. Kdur 40meq po q4h, nacl 50meq & k 20meq in 1l ns at 60ml/hr was the order. I had her on tele but the admitting doc didn't want her on the monitor going upstairs.

And this was in fast track.