What is the recommended treatment for severe hypokalemia?

• A. Intravenous potassium chloride with magnesium repletion
• B. Oral potassium chloride
• C. No replacement
• D. Hemodialysis

Answer: (C)

Severe hypokalemia must be corrected promptly because low potassium disrupts cardiac conduction and skeletal muscle function, increasing the risk of dangerous arrhythmias and weakness. The standard approach is potassium replacement, and in severe cases this is given intravenously as potassium chloride with careful monitoring. IV replacement is used when the patient cannot take potassium by mouth or when rapid correction is needed; it must be given with continuous ECG monitoring and at controlled infusion rates to avoid overcorrection and vein irritation. Magnesium plays a key role because low magnesium impairs potassium handling in cells; if magnesium is low, replete magnesium as well to enable effective potassium restoration. Oral replacement is useful for less urgent situations or after stabilization, but it is too slow for true/severe hypokalemia. Not replacing potassium leaves the dangerous electrolyte imbalance unchecked, so it’s not an appropriate management. Hemodialysis is reserved for specific situations like renal failure with other complications, not as the primary treatment for straightforward severe hypokalemia.