When thinking about repleting a potassium deficiency consider the following:
- Goal is of K is greater than 4 in any pt with active cardiac problems
- If your pt has nl renal function: 10mEq of KCl (IV or PO) will increase serum K by about 0.1mEq/L (so if your pt is at 3.6, about 40 mEq of KCl should help correct your patient)
- Don't replete if patient is on dialysis (consult the dialysis team)
- f your pt has compromised renal function: divide the mEq of normal repletion by the pt's Cr (example: pt has Cr of 3, then you use 1/3 of the nl repletion amount - so instead of 9mEq, you'd use 3mEq)
- PO can cause nausea
- IV can be painful
- Typical combos: 10mEq/100cc or 10mEq/50cc (peripheral IV) and 20mEq/50cc (central line)
- Be careful when repleting its with renal insufficiency or in pts with high risk of tumor lysis
*This is not meant to substitute for clinical judgement, just suggestions to think about when treating K+ deficiencies in your patients.
Source:
http://www.eric.vcu.edu/home/curriculum/print/Intern_Ward_Survival_Guide_2009.pdf
http://www.surgicalcriticalcare.net/Guidelines/electrolyte_replacement.pdf
photo: http://mattrosenart.deviantart.com/art/Potassium-195578504
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