How many mEq's of K would it take to kill a 54lb woman?

Zookeeper3 · May 8, 2010

You are missing the point. There is no magic dose amount. The point is any dose in excess has the ability to stop your patients heart. She wants you to know it was a near death experience for your patient. Write the paper about that.

That is the lesson.

We all have our own horror stories of near misses to tell, you are not alone and will become very OCD about meds over your career. In a few years when you are training the next generation, share your war stories like this one, it may save lives. Take care.

Sarah010101 · May 8, 2010

I did the same thing... well kind of.

I went ahead and prepared my pts. new ASA order... not looking at the allergies.. i didnt realise she was allergic to ASA. ANYWAYS.. so here i go... get the meds... take my mar.. go to the room... check name band.. literally she put them into her mouth and i saw ASA allergy on her MAR and i yelled STOOOOPPPPP!!!!!!!! she spit them back out. no damage done. THANK GOD. scared the crap out of me...

being only a 2nd year nursing student... i now overly check EVERYTHING... CHECK EVERYTHING.. 3 checks.. do your math, get people to check..

Your instructor should not punish you for calculating wrong.. thats why she is there. so you did it wrong, your a student it happens.. figure out what you did wrong, admit youor wrong.. and move on.

NBMom1225 · May 8, 2010

You could throw in a fact one of the doctors told me, but you'll have to find a reference somewhere: each 10 meq of po potassium will raise K+ levels 0.1, so if they wanted to give 60 meq KCl her K+ level should be 0.6 higher on her next lab draw. :rolleyes:

ljkeene · May 8, 2010

What a valuable lesson. Now whenever you have to calculate a medication you will be reminded of this incidence and be extra careful. You must have a good instructor that has the insight to make this into something you will always remember. It may save you from a lethal dose of some other kind of medication in the future. I remember 30 years ago as a new grad that i miscalculated a heparin dose and gave 10 times the dose I should have. I had to face the surgeon and tell him what I did. He just said to watch the patient and there were no adverse effects but that incidence was so potentially dangerous on that fresh open heart patient and the implications of what could have happen was so scary that I have never calculated another medication in the past 30 years that I did not give without being absolutely positive it was the right calculation. Great lesson to learn so early on.

Peetz, BSN · May 8, 2010

Im a nursing student and I got written up a couple weeks ago
I was giving a patient- who was only 54lbs her prescribed dose of KCl. It was via NG tube and the ordered dose was 60mEq. I had to do the math to figure out how many mL's contained the 60mEq the dr ordered and I did it real quick in my head and did it wrong and of course got in huge trouble, which I admit I completely deserved & will always write my math & double check from now on!!
Anyways my instructor is having me write a paper as punishment & part of it is to research how many mEqs KCl would it take to kill a 54lb woman?
Thanks for your help!
Ive researched this & looked in my drug book but was unable to find this...

Are you sure she was 54 lbs? and not 54 kilos? A WOMAN that weighs 54 pounds would be very, very small. That is the average weight of a 7-8 year old! There are different doses for peds and adults.

~Mi Vida Loca~RN, ASN, RN · May 8, 2010

I would look at the SSD or SD for 54 lb patient and write anything above that can be lethal.

I too and shocked it was a 54lb woman, I mean I know it's entirely possible, but I am just trying to picture a woman who I would assume is an adult (by the terminology) and she is only 54lbs :|

LoveMyBugs, BSN, CNA, RN · May 8, 2010

I would look at the SSD or SD for 54 lb patient and write anything above that can be lethal.
I too and shocked it was a 54lb woman, I mean I know it's entirely possible, but I am just trying to picture a woman who I would assume is an adult (by the terminology) and she is only 54lbs :|

At my clinical at the ED today, took care of a patient who was 30kg and about 5'2" who was in mid 30's.......every bone:eek:

PeteyPie · May 8, 2010

Look up for potassium chloride: Lethal Dose (LD 50) Efective Dose (ED 60) and Therapeutic Index.

I will get you started :) Lethal Dose 50 is the amount of a drug to kill 50 percent of the lab test animals, usually rats because they are genetically similar to people. For KCl the LD 50 is 2.5 g/kg.

diane227, LPN, RN · May 8, 2010

What was her baseline renal function? A lot depends on her baseline function and the condition of her heart and kidneys. Certainly a K+ overdose is a horrible way to die but the other question I have is why were you having to calculate this dose in the first place? Did this medication not come pre packaged from the pharmacy in the correct dose?

bartender514, ADN, BSN · May 8, 2010

Not only do you have to factor in dosage you also have to consider duration of time given. I'm sure it's standard in most facilities to give 10mEq of IV K through a peripheral line over 1.5 hrs. Giving a pt 50mEq of K over multiple hours wouldn't be nearly as bad as giving 50mEq IVP in less than a minute.....

DaughteroftheKing · May 9, 2010

Thanks everyone for your responses - espescially the ones that were encouraging!!! I definitely will never give anything I have to do math on again without getting someone else to check it! Anyways, yes she was 25 y/o with severe malabsorption and was 54lbs- not kgs- very hard to look at her... That sounds rude admitting that, but it really was... so sad.

Anyways, if I remember correctly it was in liquid form- the order was 60mEq per ng tube, and we had 2 containers of liquid (for the tube) KCl that were each 40mEq and each 30mL. I dont remember what I did but in my head I calculated the wrong mL's which would have given her the wrong mEq's of K.

Anyways, lesson learned & paper done!

Thank you all again...

ShannonFaas · May 9, 2010

And another thing to consider is how the K is administered. If you really want to increase your chances of killing someone, regardless of the amount give it by IV push.

Ouch that would burn!! And to answere the question of how much it would take, it depends on the patients cardiac threshold as to if they can handle a higher dose. Most renal patients can very easily handle it, but other patients can go into fatal arrhythmias on a 6.5 K+. :nurse: