Bolus D5NS with 20mEq KCl

[meggs0714]

I'm a new nurse and I had an order for a 1000mL bolus of D5NS with 20mEq KCl over 1 hour for a patient weight 104kg. I only know to give boluses with NS so I questioned the order and the resident changed it...but I'm curious is it wrong to give boluses if they have additives?

[applewhitern, BSN, RN]

Our policy states we can give potassium chloride at a rate of 10 mEq per hour. No, usually you would not bolus with an additive. Not knowing what was going on with your patient, and you facility's policy, it is hard to say if it would be right or wrong. We can give up to 20 mEq KCL over one hour if we have a doctor's order, but absolutely no faster than that.

[MunoRN, RN]

Typically, no, you don't bolus with D5NS w/KCL. The main concern would be the rate of KCL the patient is receiving. Typically, the max rate on non-monitored units is 10 meq/hr. Rates on monitored floors vary from 0.2 to 0.5 meq/kg/hr, or just a flat 20 meq/hr.

[NSALVADORE]

I know protocols are different at different hospitals. We generally give 10meq over 1hr (in 100ml bag). I always would question an order to bolus a fluid with an additive.. And you can always check with pharmacy to see at what rate you can run the additive safely.

[ProudToBeAnRN]

First off, a bolus is not usually given over an hour. You can give consecutive boluses within the hour, but you it's aimed to be a rapid infusion. And no, it typically does not have additives in it.