[gwenith]

Originally posted by cannoli
This was a peds question, but if it's no "P" no "K" (love it), then it must pertain to all patients, n'ces pas?

There are a lot of differences in Paediatric and adult care and this just highlihgts one of those differences. There is an old saying - children are not just tiny adults.

Todd one of the reasons why 12 lead ECG's are not done as frequently on children as adults is 1) physical limitation = smaller chests - more difficulty 2) kids are often "moving targets" so more difficult to get a good reading and 3) less likely to BE a change pre-administration. At least nothing that you could not get off of cardiac monitoring.

If the question had stated "cardiac monitoring I would be inclined to agree but it stated ECG.

[crazedredhead]

I have to go with the ability to void, or more specifically the ability to MAKE urine. Why? Elevated K+ in renal failure patients is fatal.

[cannoli]

gwenith, so are you saying that if it is an adult patient, they don't have to be able to void before giving KCL, are you saying it applies only to peds patients?

[bklyngrl]

I am gonna say B because usually in most units K is ony given if there is a cardiac monitor available( like IMC or ICU)

[uk_nurse]

I'm going to say observations are done 4 hourly (or more often if needed) e.g TPR, B.P (if needed) and fluid balance charts, where bowel movements, urine output, vomits and what they have eaten or drank are recorded on my ward for every child.so by doing these surely you will be able to monitor all the necessary vital signs needed. Am i not right?

[vemiliob]

An excess of K produces, oliguria first and then anury.
Intestinal cramps and diarrhea.

It is an eight year old child, therefore there is chest enough size to take an ECG. T waves too tall will demonstrate a serum K level beyond 5,6 mEq/liter. Besides the child must be dehydrated because the gastroenteritis, it is logical to think in K depletion.

A D5% in W 500 cc + 6 cc Na20%cl + 3 cc Kcl is our local IV therapy protocol for children dehydration.

Potassium is the principal intracellular and muscle cation. Its excess or defect lead to heart failure.

Answer B sounds to be most logical.

[twinRN04]

I've definitely gotta go with "C" The question clearly asks what you would do BEFORE giving the K so you would definitely make sure that they're body has a sufficient way to excrete fatal levels of potassium which is obviously checking urine output.

[pediRNCHAM]

First - No RN's add KCL to IVs. All KCL additives are done by the pharmacy (You'll get a Type 1 citation from JCAHO if you've got KCl on your units!!!). As far as clinical assessment of the pedi patient before having IVF w/KCl, patient needs to have voided before hanging the K. Renal function needs to be validated before using KCl additives

[uk_nurse]

[quote]Originally posted by pediRNCHAM
[b]First - No RN's add KCL to IVs. All KCL additives are done by the pharmacy QUOTE]

That is true and i pointed this out in an earlier post on this subject

[TCH pedi nurse]

They gotta pee before you add K+!
Most of the patients we get from the EC have orders to add K+ Once the patient voids!

Hasta