I have a question regarding the administration of IV potassium. I recently graduated from nursing school, so I am always trying to learn and I ask a lot of questions. I received an order from doctor to run a potassium bolus over 1 hour. When the potassium came down from pharmacy they had typed on the label to run it over 1 1/2 hrs. I had read somewhere that potassium should not run faster than 10meq/hr peripherally which at the concentration supplied would have been over 1 1/2 hrs. So I asked my preceptor which one I should go with. She said that I should always follow the MD's order, but that if I was worried about it then SHE would hang it. (I think she was tired of me asking questions.) So she goes into the room, hangs the potassium (which I had already primed), sets the pump to run it in over 1 hr, hooks it up to the patient, and she leaves the room. Well a few minutes later I heard the pump beeping so I went in to check it. In her rush, the preceptor had not hooked the tubing up to the pump (even though she had set the pump) and the potassium would have been running in at a wide open rate. Fortunately, for some reason, when I primed the tubing I had clamped it off and when the preceptor hung it she did not unclamp it which caused the pump to beep. So the K+ did not run in at the wide open rate that it would have. I told the preceptor about this and she said that I needed to stop worrying and that it is okay for potassium to run without a pump. (She did not mention anything about it running wide open). She said that there will be times when I dont have a pump and I will have to run it without one. So my question after all that is....can potassium run without a pump? Is it safe? If not what rate can it run in peripherally? Was the preceptor correct? Thanks.
Our hospital has a policy. If a Dr. orders 30meq you will be sent 3 IVPB's with 10meq each, to run over one hour each. (alway on a pump)
Last edit by kyti on Jan 10, '05
I know I'll get spanked for this but sometimes I run K+ without a pump. I will use microtubing and administer it by gravity eyeballing (or timing) the drips to make sure it goes in over at least 30 minutes through a central line.
I do this very conscientiously and actually all meds I put into a patient through their vasculature gets the utmost attention. I may be replacing K+, Cacl, and mag all at the same time while pushing epi or neo or blood or whatever. I'm more inclined to hang the K+ piggyback on the pump and drip in the other two but sometimes it just doesn't work that way when things are moving fast in the ICU and all the ports of a central line are in use with drips, drugs that may be incompatible, etc, I just have to and I'm bedside the entire time of the infusion.
But normally I run all KCL replacement piggyback on the pump. And I would never do this on a patient who's able to move around which is rare to nonexistent in this situation.
Last edit by begalli on Jan 12, '05