can you add KCL to IVF?

Nurses General Nursing

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can nurses add kcl to the iv fluid bag? i think nurses were allowed to admix medication to the bag, like vitamin b or other medications. but i dont know it can be done nowdays

Specializes in Telemetry/Med Surg.

It's now typical for pharmacy to do it, or to have pre-mixed bags from a manufacturer.

That's how it is where I work.

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Specializes in Psych, Med/Surg, LTC.

We used to be allowed to, but now we aren't. The state didn't want us doing it anymore. Now we get premixed IVF bags.

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As stated by other, now comes from pharmacy, even premix manufactured fluids have been cleared by pharmacy. Unless it's an emergency situation, the pharmacy would rather mix all additives in the IV. So we do not have vials of much in the fridge. Some of the smaller facilities may still rely on the nurses for this but most do not here.

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Specializes in Neuro ICU and Med Surg.

We aren't allowed to do it. 0.9ns + 2omeq KCL is our standard IVF so we can get it from floor stock. Otherwise it comes from pharmacy. We also have 20meq/100ml IVPB potassium also for our replacement protocol that can only be infused through central lines or piccs.

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Specializes in Med/Surg and Wound Care, PACU.

in germany we always mixed our own stuff, no pharmacy there

never had any errors happen, it is the norm

no big deal

nici

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We have premixed bags of D5-1/2NS w/ 40mEqKCl per liter.

If not emergency and pharmacy is open, we are supposed to have pharmacy make up any other preparations w/ KCl.

We also stock premixed bags of 10mEqKCl/50mL. We use these little bags to piggyback w/ liters of NS, or some nurses draw the fluid from these little bags into syringes and inject into liter bags of IVF prn.

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We have premixed bags of D5-1/2NS w/ 40mEqKCl per liter.

If not emergency and pharmacy is open, we are supposed to have pharmacy make up any other preparations w/ KCl.

We also stock premixed bags of 10mEqKCl/50mL. We use these little bags to piggyback w/ liters of NS, or some nurses draw the fluid from these little bags into syringes and inject into liter bags of IVF prn.

Something tells me that is against policy.
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Unfortunately, we don't have pharmacy 24/7 so our policy allows for us to use the KCl piggybacks.

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Specializes in Executive, DON, CM, Utilization.

It depends entirely on your hospital policy and procedure.

The outcomes of a wrong mix with potassium is the end of

life. It is the first and foremost statement made during

nursing school. However, if you are to do this your facility

should provide "training" during orientation and follow up, and

I agree with the writer (above) who has someone watch her;

this is not something you want to err on. Anyone needing

K+ IV is unstable as it stands most here are well aware of

the causes and outcomes of hypokalemia. I would also keep

yourself abreast of all recent labs; meaning is this patient in

need of K+ what were the levels; et al. Dehydration will

show a false high on labs, and edema can also show a false

low; this is not just following an order--this is a potential

life-threatening intervention.

Remember the level of normalcy on K+ on blood levels is

very slight; the addition or reduction of same can cause

a life to end--cardiac outcomes of such magnitude that

unless fully prepared, overseen, and nursing staff fully

versed on lab values and reading the same should not

routinely do this intervention.

Karen G.

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It isn't a matter of what the patient's K+ level is, or if someone witnesses you mix it. It's the danger of having KCl stocked on the floor, period.

Many years ago, we mixed our own bags. Our floor stocked 30cc KCl vials in the med room side-by-side with saline vials of the same size; not only were they stocked immediately next to each other, often vials of one would fall into the box of the other.

Every day I worked I would move them as far away from the saline as I could, and put a HUGE sign up on the shelf "KCL!!!" Then every day I came back to work, pharmacy had moved them back beside the saline.

One crazy-busy night, I happened to stop my charge nurse to ask her a question as she went down the hall to access a port on a new admit. There sitting on her tray, amidst the dressing kit and the huber and tubing and syringes was a vial of KCl.

We both filed an incident report on this, and shortly thereafter the KCl stock was removed from all patient units.

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Every day I worked I would move them as far away from the saline as I could, and put a HUGE sign up on the shelf "KCL!!!" Then every day I came back to work, pharmacy had moved them back beside the saline.

One crazy-busy night, I happened to stop my charge nurse to ask her a question as she went down the hall to access a port on a new admit. There sitting on her tray, amidst the dressing kit and the huber and tubing and syringes was a vial of KCl.

Yikes!!! Thank god you saw it on her tray! That stocking situation was a sentinel event waiting to happen.

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Specializes in Executive, DON, CM, Utilization.

Good Morning!

I stand by my original commentary thank you!

You are totally responsible for your knowledge base; the facility you work at for their policy and procedure on this potentially life-threatening medication.

Last I checked this is a "nursing forum" and within our separate levels of nursing licensure and accountability we are trained about K+.

One had better be aware of K+ levels, normal, the diagnoses of the clients and the outcomes; this is part of basic standard of care.

Karen G.

I do not check in daily so am replying when I do!

It isn't a matter of what the patient's K+ level is, or if someone witnesses you mix it. It's the danger of having KCl stocked on the floor, period.

Many years ago, we mixed our own bags. Our floor stocked 30cc KCl vials in the med room side-by-side with saline vials of the same size; not only were they stocked immediately next to each other, often vials of one would fall into the box of the other.

Every day I worked I would move them as far away from the saline as I could, and put a HUGE sign up on the shelf "KCL!!!" Then every day I came back to work, pharmacy had moved them back beside the saline.

One crazy-busy night, I happened to stop my charge nurse to ask her a question as she went down the hall to access a port on a new admit. There sitting on her tray, amidst the dressing kit and the huber and tubing and syringes was a vial of KCl.

We both filed an incident report on this, and shortly thereafter the KCl stock was removed from all patient units.

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