Quote from KAT1994
At our unit we have standing orders: K+<4 =4k, K+<5=3K, K+<6=2k, K+>6=1k w/a stat re-check the next tx, MD, and dietician are notified. We only move up or down one bath; for example, k+ of 3 goes to 5.4 they are only moved to a 3k instead of a 2k bath. I would probably re-check k+ in a week or two. Our dieticians work with the pts very closely and for the most part they don't fluctuate that much. We check labs at least once a month.
We too, have standing orders for the dialysate baths.. for both acid and bicarb.
They are as follows:
K+ levels 3.5 or < ... 3k bath
K+ levels 3.6-6.4 ... 2k bath
K+ levels 6.5 or > ... 1k bath
Bicarb settings on machines go by sliding scale, according to the monthly lab draws.
Any new patient is started on a standard setting of 35.
Thereafter, anyone having < 22 would be bumped up to a bicarb setting of 38.
Anyone < 16 would be set at 40.
Results of 22-25 (target) is maintained at their current setting.