OSCE: Hypokalemia
Journal Title: Journal Of Pediatric Critical Care - Year 2018, Vol 5, Issue 6
Abstract
Eight years female ,weighing 15 kg, known case of diabetes mellitus for one year, presented with history of fever 3days, polyuria, vomiting and respiratory distress one day. HR 120/min. RR 34/min, CRT <3sec, SpO2 100%. Her lab reports are Hb 6.7gm%, TLC 12000/cmm, polymorphs 85%, platelet count 2.0 lac, blood urea 26mg/dL, blood sugar (R)>500mg/dL, serum creatinine 1.0mg/dL, sodium 155mEq/L, potassium 1.6mEq/L, chloride 74mEq/L, ionised calcium 0.89mmol/L and x-ray chest revealed pneumonitis right side. ABG showed pH of 7.11, PCO2 35, PaO252%, HCO3 - 7.8, BE -19, A-aO2 82 and ECG revealed T-wave inversion. Child was put on oxygen therapy, fl uid bolus, N/2 10% DS, potassium free fl uid, insulin infusion and ceftriaxone. Repeat serum potassium was 1.7 and <2mEq/L done after every 6hour of treatment. TTKG was 8. Serum magnesium received 24hr later was 1.2mg/dL. Urine was positive for sugar and ketone bodies and negative for proteins and RBC’s.
Authors and Affiliations
Kundan Mittal, Lalit Waghmare, H Aggarwal, Manish Munjal
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