Low-K Lena — Hypokalemia
Flat T waves, U waves, silent belly, never IV push
Lena takes her water pill faithfully and eats almost nothing. Her heart's tracing flattens out, her bowel goes silent, and a U wave shows up on the monitor like a signature at the end of every beat.
Lena's K⁺ is below 3.5 from diuretics, vomiting or NG suction. Everything gets flat and quiet: flat T waves, U waves, weak muscles, absent bowel sounds. Replace potassium slowly — diluted, on a pump, never IV push, never faster than 10 mEq/hr on a general floor.
Read Low-K Lena's full story →The story arc
The setup
Furosemide daily for heart failure, a week of poor appetite, and no potassium supplement refilled.
The turn
Her legs feel rubbery on the stairs, her belly bloats, and the nurse cannot hear bowel sounds.
The crisis
The monitor shows flattened T waves with a U wave, then a run of PVCs. She also takes digoxin.
The save
Diluted KCl runs on a pump through a good IV site with continuous ECG monitoring — never a push, never undiluted.
NCLEX study section — Hypokalemia
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Endocrine & Metabolic
Take this chapter into practice questions on the same topic.