Hanging IV Potassium

[MrsMinor]

What is the normal procedure you use when hanging KCL? Meaning, when you admin it how is it diluted??

I had to hang 2 bags of 20 meq KCL diluted with 100cc saline each--one after the other--this is premixed by the pharmacy & sometimes they'll add lidocaine to it since it can be very irritating to the veins.

Is this how most of you hang potassium or do you usually dilute it more? This seems to be the norm on my floor, but one nurse passing thru was very surprised it wasn't diluted more. Your feedback appreciated!

[VivaLasViejas, ASN, RN]

What Deb and Siri said.

[daisybaby, LPN]

Good topic- let's keep it productive. We get ours from Pharmacy as 20 mEq KCL in 1000cc 1/2 NS. Usual orders are to infuse at 125cc/hr peripherally. I haven't been a nurse for too long, but so far I've never had a pt complain about burning when it's infused in that manner.

[live_N_scrubs]

Good topic. I'm still in orientation and we hang K riders quite often where I work so I still have questions about how to run it. So this has been a great education for me.

We also give maintenaice fluids, D5 1/2 with 20, 30, 40 meq KCL. But for example the other day I had a pt who came post op with a potassium level of 2.6, so the doctor ordered a K rider. It was 10 meq diluted in 250 cc NS. We normally start them out at 10 cc/hr and increase or decrease depending on if it burns or not. I think it also depends on the size of the vien and the size of the IV gauge. If it's a small vien with an 18 or 20 gauge, yes it will burn. But if you have a larger vien to run the K rider, it will not be as bad. Also at our hospital, we run the k rider on a totally separate pump. This is done to prevent accidently running it to fast and causing damage or worse causing heart problems. FYI, the pt who was hypokalemic, her labs came back with a 2.2 potassium level even after the k rider so the doctor had to order even more potassium in her maintenance fluid plus another k rider. I left for the day so I don't know what happened after that.

Thanks for the great discussion, Marina

[turkpea]

I think that sounds pretty standard although the lido is new to me! But I think it is a great idea! How much lido is used though as it can be irritating to the heart!