Hypokalemia can present with generalized weakness, palpitations, or, rarely, paralysis.35 Data from a review of 43,805 patients have shown that patients with severe hypokalemia typically present with weakness and myalgias.35 Hyperkalemia can also present as generalized weakness, ascending paralysis, palpitations, and paresthesias. More importantly, the emergency clinician should ask questions targeted at the underlying cause that may have led to a potassium derangement, including history of kidney failure, gastrointestinal complaints, and thyroid disorders. A review of the patient’s medications should be performed to determine whether any drug interactions can be implicated. Previous records and laboratory values should also be reviewed to assess for a pattern of potassium derangement.
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