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Discussion

Bumex drip and lab draw

I had a patient today on a continuous bumex drip at 2mg/hr. The hypokalemia and lab draw protocols were in place so I was able to order a K+ level whenever I wanted. Thing is, I'm not sure how often I should have had it drawn. The protocol states when a K+ level should be drawn after a dose of K+ has been given but if the K+ is within normal limits how long would you go before having another K+ drawn? The only other fluids were NS at KVO and some antibiotics. No routine K+.

I kept getting different answers from different nurses and the MD just answered "You have the protocol ordered..."

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with k+ protocol at my hospital once its wnl... it stops. If the doctor wants levels drawn after that then he/she has to put in an order. check with your charge they should be able to clear it up for you.

Where I work, our K replacement protocol is for IVPB KCl and we check K level Q6. Then depending on their K level, we replace it with anywhere from 10 to 40 mEq based on the result. If it's normal, we wait 6 hours to recheck. If the patient is normal after multiple draws, we're usually asking to d/c the K replacement protocol.

Our protocol requires a recheck the next morning if your last result is normal.

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