In unstable hypokalemia, what is the recommended route for replacement?

• A. Unstable hypokalemia should be treated with oral potassium
• B. Hypokalemia should not be corrected
• C. IV potassium is never used
• D. Unstable hypokalemia requires IV potassium chloride

Answer: (D)

When potassium is dangerously low and the patient is unstable, you must replace potassium quickly and under close monitoring. Oral potassium cannot reliably and rapidly raise serum levels in an unstable patient, and delays or poor absorption could allow dangerous arrhythmias to continue. The intravenous route lets you deliver potassium directly into the bloodstream in controlled, titrated amounts while you monitor the heart and electrolytes. Potassium chloride given IV is the appropriate method in this urgent setting, with careful dilution and gradual infusion to avoid irritation or rapid shifts.