Table 2b -- Treatment of hypokalemic hypochloremic alkalosis Condition Treatment Mild hypokalemia 1 mEq/L K+ decrease = 200-400 mEq total body deficit Severe hypokalemia K+<2.5mEq/L = 400-800 mEq total body deficit EKG changes, neuromuscular symptoms Rx = 40-60 mEq KCI p.o. Monitor serum K IV KCL 10 to 40 mEq/hr depending on severity (10 mEq/hr normally, 40mEq/hr if K<2) Continuous EKG monitoring, check serum K q4h Severe Alkalosis (pH>7.55) Check ABGs and serum electrolytes q4h. In renal failure pts, hemodialysis can correct alkalosis Acid therapy -- use with caution Calculate H+ deficit (mEq) = 0.5 x lean body wt (kg) x [(measured HCO3) - (desired HCO3)]. Replace half the deficit over 12hr, remainder over next 24hr HCl solution = 150ml HCl in 1 liter sterile H2O.