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Special Situations A) Diuretic-induced hypokalemia Consider potassium-sparing agents Adjust diuretic dose if appropriate B) DKA (Diabetic Ketoacidosis) Potassium may be low even if initial value looks normal Potassium must be monitored closely while treating with insulin C) Renal impairment Replace cautiously Risk of overcorrection Quick Exam Points Oral K = preferred unless emergency ECG changes urgent IV replacement with monitoring Magnesium MUST be corrected Never give potassium as IV push Replace slowly to avoid rebound hyperkalemia