Iv mag or k+ which do I hang first?

Specialties Emergency

Updated:   Published

Recently I had a patient that needed both iv k and iv mag. The patient had one patent iv site. I hung the potassium 1 st because it would take the less time. Then get the mag started. When handing off my patient the RN told me that the mag should go first because it is what the k will stick to. I had not heard this before and am unable to find any information on this. Has anyone else?

Specializes in Trauma/ED.

I was merely being facetious. This is an interesting topic and I was pointing out that it is not a typical discussion that is had in ED's, but rather one that my ICU friends would spend time looking up.

I'm wondering if those ACTUAL ED nurses were offended by my sense of humor, if so, I apologize to YOU. If you have never worked in the ED you may not understand the normal ED mindset...life is too short to be so serious!

Cheers...

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I knew you were being facetious. Did you not see my response?

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Larry77 said:
Isn't this an ED Nursing thread? Start another line and run them both if you are worried about running them together. Save me from this ICU'ish intracellular speak ?

Sounds like most of the ED nurses I know... ?

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Specializes in Family Nurse Practitioner.

Had the same thing the other day. Mg 1.7 and K 1.9. The previous day, the patient's Mg was 1.9 and K was 1.8. She was given IV potassium and the K barely moved. I gave her 2g Mg yesterday and 800mEq po potassium. Today K was 3.1 and Mg 1.9.

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Specializes in cardiac-telemetry, hospice, ICU.

Just yesterday I had an order to run both K and Mg. I called pharmacy and was told they are Y site compatible, so I ran them both through a Y site, problem solved. They were scheduled for the exact same time.

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Stcroix said:
Just yesterday I had an order to run both K and Mg. I called pharmacy and was told they are Y site compatible, so I ran them both through a Y site, problem solved. They were scheduled for the exact same time.

Yes, they are compatible. That's not the issue.

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Specializes in Critical Care.
~*Stargazer*~ said:
There is no inhibition of potassium uptake. Potassium is flowing into the cells just fine. The problem is that magnesium blocks potassium secretion back OUT of the cell, and with low intracellular mag levels, potassium is allowed to freely exit the cell. So, potassium uptake is not affected, and secretion is increased.

Net uptake refers to the amount that remains in the cell, when you scoop up water with a colander the amount that comes back out immediately isn't counted as net uptake since it comes back out as fast as it goes in. You aren't infusing potassium directly into the cells, you're infusing it into the serum and then depending on uptake to get it into the cells, without sufficient magnesium much of it able to leak right back out, reducing net uptake. If the potassium stayed in the cell for any significant amount of time and then leaked out I might agree with you.

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Okay, so we're arguing about semantics, then.

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Specializes in Med/Surg, LTACH, LTC, Home Health.
JenniferG RN said:
Recently I had a patient that needed both iv k and iv mag. The patient had one patent iv site. I hung the potassium 1 st because it would take the less time. Then get the mag started. When handing off my patient the RN told me that the mag should go first because it is what the k will stick to. I had not heard this before and am unable to find any information on this. Has anyone else?

If this is a peripheral IV, (not to mention the correlation between potassium and arrhythmias), potassium in my experiences at work, will more than likely run longer than magnesium. K+-riders burn like the dickens. Of course, the amount of time will depend on the amount of potassium and its diluent.

http://www2.kumc.edu/pharmacy/Policies/Pharmacy%20and%20Therapeutics/Potassium%20Infusions%20Policy.pdf

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Larry77 said:
Isn't this an ED Nursing thread? Start another line and run them both if you are worried about running them together. Save me from this ICU'ish intracellular speak ?

You know, Larry, ED nurses and ICU nurses might have more in common than you'd like to think!

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Yes it was a peripheral iv NS @125/' then a 40MeQ mixed In a 250ml bag of NS bag was piggy backed in. W a 2 gram in 50ml NS bag of mag to also run at the same time. The patient was a tough stick and Was only going to the observation unit I didn't see a need to start a second site. Our pharmacists did not recommend running them at the same time d/t possible overload. On a side note ; I'm so thankful I joined this site- there is so much insite, knowledge and comedy. I wish I would of known about this years ago.

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...hmm that's odd that 2g of Mg would take longer to infuse than 40mEq of K+.... you can run mag in pretty fast.

As was previously mentioned, they're compatible so you didn't need a 2nd site. If you're worried about fluid overload, mag first, K+ second.

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