K+/Mag replacement protocol - page 2

by Sugarcoma 7,829 Views | 11 Comments

A question that I have been unable to find an answer to at my current job about mag/k+ protocol. This protocol is ordered on everyone admitted to our ICU. Usually by the nurses as the docs themselves RARELY put in admission... Read More


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    We have standing replacement protocol orders on nearly every one of our patients. Like most posts, we do not replace HD patients but do check levels every AM. However, we also do CRRT on my unit and we DO replace and have a special order set for them. I'm not too sure about the TPN. As far as I can remember, we still replace 'lytes on TPN patients but that would be a good question for your manager or someone seasoned on the unit.
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    Our K protocol is adjusted in the orders based on creatinine levels. I think you need to take in account all facts per individual patients before given electrolyte replacement. Magnesium does not have a protocol on our unit for our s/p CABG. The patients under the care of our critical docs have replacement criteria for everything. I feel that if you are ever questioning giving a dose, call the MD and ask for parameters related to creatinine level. As far as TPN goes call the pharmacist who mixes and ask about replacement. There is no wrong answer. If the patient is on diuretics than K may need to be replaced. We check one hour after infusion is complete. For HD patients, the electrolytes are usually replaced by HD Rn and MD. Hope this helps... Ask your coworkers, it is always good to get a consensus.


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