Published Feb 9, 2008
Ms.RN
917 Posts
can nurses add kcl to the iv fluid bag? i think nurses were allowed to admix medication to the bag, like vitamin b or other medications. but i dont know it can be done nowdays
ZippyGBR, BSN, RN
1,038 Posts
the problems with adding potassium to fluids are multiple the main two however are
1. 'layering' influids where the potassium is added at ward level
2. the risks associated with neat potassium chloride solution on the units
certainly here in rightpondia we can get 20, 27 , 40 , 60 and even 80 mmol/l KCL in .9%NaCL, 5%Dextrose and dextrose / saline as stock items from our fluid suppliers
jojotoo, RN
494 Posts
Some institutions do allow nurses to prepare IVF with certan additives. But I thought that all vials of KCL were kept in the pharmacy now (and not on the unit) due to errors where KCL had been given as a direct IVP.
BrnEyedGirl, BSN, MSN, RN, APRN
1,236 Posts
We still mix many of our own drugs,.mostly antibiotics (have mixed feelings about that) but we haven't been allowed to even keep IV KCL unless it comes premixed from the manufacturer or pharmacy in years! I remember hearing the horror stories of the nurse who mistakenly pulled up KCL instead of NS for her morning HL flushes!! That story has always given me the chills and I'm glad I don't even have the option of grabbing the KCL by mistake!
Virgo_RN, BSN, RN
3,543 Posts
Pharmacy does that at my facility.
XB9S, BSN, MSN, EdD, RN, APN
1 Article; 3,017 Posts
As ZippyGBR has already said, we are not allowed to add KCL to IV fluids in the UK except in ICU
crb613, BSN, RN
1,632 Posts
We do add K+ where I work as well as mix antibiotics. I work nights...no pharm at night. I am always very careful with all especially K+....SHAKE heck out of the fluid & NEVER set the potassium bottle down. I always have another nurse watch & double check my calcs. I'm not a fan either!
EmmaG, RN
2,999 Posts
Years ago we did; now they are either premixed from the manufacturer or pharmacy does it. My ex-manager told me of a nurse she worked with in Texas who had an order changing the existing IV to the same fluids with KCl added. She injected it into the port of current running IVF and thus gave the patient a rapid bolus of K+... patient did not survive
Tweety, BSN, RN
35,420 Posts
When I first nursing we were doing this.
Yes, nurses are allowed per their license to do it.
However, the problem wasn't necessarily that we were bad at it, but having KCL vials llying around set us up for med errors and around the country a few deaths occurred when nurses drew up KCL thinking it was something else like saline.
It's now typical for pharmacy to do it, or to have pre-mixed bags from a manufacturer.
catlover13
67 Posts
Hi,
At my facility, a small rural hospital, we do mix KCL in IVF. Also mix IV antibiotic therapies.
It's been a great learning experience.
:paw:Can't resist the pawprint!!!
Catlover13
SICU Queen
543 Posts
Years ago it was very common for nurses to add it themselves... but nowadays it usually comes from pharmacy due to the fatal end result if it's administered incorrectly.
(Basically, what everyone else has mostly already said... hehe.)
jlcole45
474 Posts
Yes - just follow your facility's/floor's protocol and label it correctly.