Repleting K+

Electrolyte imbalances are something that you see a lot on your rotations - especially in internal medicine, emergency medicine, and surgery.

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.

photo: http://mattrosenart.deviantart.com/art/Potassium-195578504

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