Crushing K-Dur

banditrn · Jun 15, 2006

There are so many forms of K+ that can be administered by feed tube - if they are crushing the Kdur, that should be considered a med error.

VickyRN, MSN, DNP, RN · Jun 15, 2006

information from the manufacturer of k-dur concerning crushing:

information for patients: physicians should consider reminding the patient of the following:
to take each dose with meals and with a full glass of water or other liquid.
to take each dose without crushing, chewing, or sucking the tablets. if those patients are having difficulty swallowing whole tablets, they may try one of the following alternate methods of administration:
a. break the tablet in half, and take each half separately with a glass of water.
b. prepare an aqueous (water) suspension as follows:
1. place the whole tablet(s) in approximately 1/2 glass of water (4 fluid ounces).
2. allow approximately 2 minutes for the tablet(s) to disintegrate.
3. stir for about half a minute after the tablet(s) has disintegrated.
4. swirl the suspension and consume the entire contents of the glass immediately by drinking or by the use of a straw.
5. add another 1 fluid ounce of water, swirl, and consume immediately.
6. then, add an additional 1 fluid ounce of water, swirl, and consume immediately.
aqueous suspension of k-dur tablets that is not taken immediately should be discarded. the use of other liquids for suspending k-dur tablets is not recommended.

http://www.spfiles.com/pikdur.pdf

AuntieRN · Jun 16, 2006

I do not mean to sound stupid or anything by asking this ( I am a student in my last semester..YAY!!) but....isn't K-DUR a form of potassium? We were always taught you were not supposed to ever crush potassium....is this correct? or is K-DUR different and you just do not crush regular straight pottasium...or is there even a difference? Thanks yall.....

HappyNurse2005, RN · Jun 16, 2006

yes, k dur is potassium.

ONSnrs · Jun 16, 2006

[

NURSE B: "We can't crush K-Dur."

NURSE A: "I know but that's what the doctor ordered, so that's what I gave. It's not my problem."

eeeek, and would you knowingly do something that would hurt a pt. and jeopardize your pt. just because the doctor orders it?:angryfire

lpoore · Jun 22, 2006

She could also have given it PR (per rectum). I work in hospice and a lot of our patients are unable to swallow or comatose so in order for us to give their meds we will give them PR. So, so sad that there are nurses out there that don't care. Most of them are in it for the money.

Linda

Beary-nice · Jun 22, 2006

She could also have given it PR (per rectum). I work in hospice and a lot of our patients are unable to swallow or comatose so in order for us to give their meds we will give them PR. So, so sad that there are nurses out there that don't care. Most of them are in it for the money.
Linda

So I am wondering then how it is absorbed given rectally? What I am saying is there a greater chance for gastric ulceration and perforation if you give potassium chloride in this manner? I have never heard of this and everything I have read indicates that KCl is to be administered po or IV. Would you be willing to give more information about this?

jebrn2 · Jun 22, 2006

Personally I have crushed kdur, more then once. The Pharmacy where work is a very helpful resource, if I doubt an order or question anything, I call and ask them them first. Many times as lonf as the dug isn't change(dosage), then they will give me an exceptable substitution. On the other hand, administering a med that a dr orders just because, is your problem.

IT would your license on the line if something happened. like giving a med you know the pt is allergic to.

Beary-nice · Jun 22, 2006

Personally I have crushed kdur, more then once. The Pharmacy where work is a very helpful resource, if I doubt an order or question anything, I call and ask them them first. Many times as lonf as the dug isn't change(dosage), then they will give me an exceptable substitution. On the other hand, administering a med that a dr orders just because, is your problem.
IT would your license on the line if something happened. like giving a med you know the pt is allergic to.

It is also your problem if you are giving a med in a manner that it is not intended to be given and also if the pt then experiences complications and/or a prolonged hospital stay because of your actions. K-Dur is in a waxy coating for a reason. It is also in those tiny microbeads that the tablet is made up of for a reason. To alter that is to put a pt at risk for a high local concentration of KCL in the GI tract and can result in ulcers, bleeding, perforation, and death.

chadash · Jun 22, 2006

She could also have given it PR (per rectum). I work in hospice and a lot of our patients are unable to swallow or comatose so in order for us to give their meds we will give them PR. So, so sad that there are nurses out there that don't care. Most of them are in it for the money.
Linda

Does K dur come in suppository form? How much electrolyte absorption do you get in the rectum, wouldnt it need to go through some catabolism in the intestine? Don't know. Ooops! catabolism is the wrong word, isnt it....

Beary-nice · Jun 22, 2006

Does K dur come in suppository form? How much electrolyte absorption do you get in the rectum, wouldnt it need to go through some catabolism in the intestine? Don't know. Ooops! catabolism is the wrong word, isnt it....

I do not know of KDur in a suppository form. Most absorption of nutrients occurs in the small intestine you are correct about that. KDur is potassium chloride and the only approved methods of administration that I know of for potassium chloride is oral and IV.

HisHands, ASN, RN · Jun 23, 2006

If someone is on hospice - comfort care only, why would they be getting a potassium supplement anyway? And of all ways, rectally... neither drug nor method seem very comfort care friendly to me.