Hey all. Experienced ICU RN here. Doing agency at a super small 26 bed hospital that have worked at on and off for a while. Had a pt come up from the ER with critical lab results. Way off, like a K 1.9, Na 117, Chloride 70, etc. Pt totally asymptomatic. The MD wanted me to start giving K riders before the stat repeat labs were drawn to confirm the above results. I said no way. Not until I get my labs redrawn. Mind you, above MD told the On call lab tech he just wanted the labs redrawn in an hour or so. So lab took forever to come in. Pt still asymptomatic. Labs redrawn with levels being about the same, so my results were true and not bogus. So I gave the K riders, a total of 30mEq KCL IVPB over 3 hours. Next K was 2.2 and the MD just ordered PO KCL (only reason I know this is cause I called my unit, was working on a med surg floor for 4 hours to help them out.) Anyways, MD is pissed that I did not start the KCL right away. My experience has ALWAYS been to recheck those labs first, specially if pt is asymptomatic. I mean if a blood glucose was off the charts high or low we would recheck that. Probably will end up getting written up for that, but I stick with my decision. Just wanted some input though. TY in advance.
So what do you all think?
Sorry I am rambling. Been up way too long and hoping to pass out for a while soon.