I am a new nurse on a MSP unit. But I am noooooo dummy.
A family member of mine was admitted to the ICC today where I work with acidosis. I left my shift early and sat in the ER with her till she could go to her room. As I sat there I noticed a 250ml bag of 20meq Potassium running into her. So I asked the nurse what that was for....no real answer...I asked what her Potassium was....was later told 5.2 (I know most norms are 3.5-5.5/5.1/5.0 or a variation, 5.2 is considered low at this hospital). It didnt really register till I got upstairs with her and started to see her vitals deteriorate more and more, I actually had time to formulate. Blood pressure was prehtn upon admission to ER and within a few hours hypotn. No previous cardiac history, now has pronounced JVD, third spacing, edema.....
I kept asking.....why this bag was hung? Does this have an effect on the intracellular exchange that occurs? If her K+ is 5.2 why is she getting Potassium?
No one knew why......there was no order for it in the MAR or MAR summary....leads me to believe this is a medication error and hung on the wrong individual because people started to cover their asses as soon as I mentioned this.
The question I pose is this.....
What would be the reasoning for infusing a bag of 250ml 20 meq potassium for this individual? Is this related to the intent to correct the :mad:acidosis, the high CO2 and retention? Will this correct it?
No one could answer this for me!!!! And I was acting proxy!!!!
And it seemed to be of no concern to anyone that this person received this potassium, had no MAR/order history documented, and appeared to be slowly entering into a state of shock.
I really need an answer! I plan on pursuing this issue later, but right now I would like to know what exactly why potassium is needed in a state of acidosis (undefined but retaining CO2) for an individual that has a K+ lvl of 5.2?
BTW my 90 yo mom did not have DM or >glucose level. In fact, this frail 90 yo woman has labs anyone would love to have. My problem, other than hyperkalemia, is getting her to eat protein. She would prefer to eat her veggies and does not care for sugar or bakery stuff. Suppose that is why she is 90 and has labs that we would all envy. Apparently her food preferences were not inherited by me--darn.
Megan, your situation may not even relate to the OP's question however. The OP specifically stated acidosis. The presence of an acid base derangement has direct consequences to the concept of potassium movement.
Clearly, we are walking a thin line regarding TOS and medical advice;however, I think I have been careful to utilise arbitrary situations to make a point without directly telling the OP anything about their situation. With that, it is still important that we appreciate that the current situation involves both an acid base and electrolyte imbalance.
Megan, your situation may not even relate to the OP's question however. The OP specifically stated acidosis. The presence of an acid base derangement has direct consequences to the concept of potassium movement.
Clearly, we are walking a thin line regarding TOS and medical advice;however, I think I have been careful to utilise arbitrary situations to make a point without directly telling the OP anything about their situation. With that, it is still important that we appreciate that the current situation involves both an acid base and electrolyte imbalance.
It is good; however, that you caught an error.
From what I understood, the writer was tossing out an idea and seeking clarification. We do that all the time here and people often respond with their experiences. Clearly the writer will need to research the problem at length to find her answer. If anyone came to the conclusion I was offering medical advice, then...hmmmm. I am going to reread my post. Sometimes I forget that I changed professions from that of a malpractice paralegal to nurse/social worker. Sorry if anyone felt I was giving medical advice...and you know what they say about free advice...it is as good as what you paid for it.
No, I was placing emphasis on my earlier posts and how my intent was not to provide advice per se, but rather discuss some of the physiology of acidosis and potassium relationships.
MeganS
90 Posts
BTW my 90 yo mom did not have DM or >glucose level. In fact, this frail 90 yo woman has labs anyone would love to have. My problem, other than hyperkalemia, is getting her to eat protein. She would prefer to eat her veggies and does not care for sugar or bakery stuff. Suppose that is why she is 90 and has labs that we would all envy. Apparently her food preferences were not inherited by me--darn.