Calcium Gluconate

[SweetMelissaRN]

Question, over what period of time do you give an amp of calcium gluconate to someone who is not coding? Had to give this to a pt with hyperkalemia last night and all the resources I read just said to push slowly, but didn't give me any period of time... I gave it over 4-5 minutes, but my pt still had a drop in hr, bp, became flushed, and said her heart felt like it was going to jump out of her chest, which makes me think I should have given it slower?

Just want to get some other insight! Thanks :)

[Sandman2855]

The first time I gave this medication, it was for a non-coding hyperkalemic patient. I asked a colleague if there was anything special I needed to know about the administration of these medications (also giving sodium bicarb, insulin, dextrose). She said "nope, just push em". Immediately after pushing my meds, the patient started freaking out and saying she she felt "funny" and had shortness of breath. Her vitals were stable and her rhythm were fine, but I wont "just push" these meds again. Seeing this thread, I am guessing it was the calcium gluconate.

Side note: An ED doc explained to me the difference between calcium chloride and calcium gluconate. He said you give calcium chloride to a coding patient because it is more effective but is a stronger vesicant and coding patients dont care. Calcium gluconate hurts less but needs to make a liver pass before becoming activated, which means it is less effective in coding patients with their... questionable... circulatory status..

[Adenosine6]

Something a Nurse told me that I will ever forget:

"When you are pushing any Core Electrolyte (Chem 7-10's), push them SLOW!"