How do you run K+??

[mariedoreen]

So the order is to run the K+ (mixed with NS) IV over 2 hours w/ another bag of NS to decrease vein irritation... The patient has one IV access and has a primary fluid already infusing, let's say D5 1/2 NS w/ 20 K at 150...

So... I asked the charge and another RN how to do this.

One says you need 2 pumps, the first pump has your main fluid. The second pump has the K+ with a bag of NS piggybacked in as an end flush. It won't run with the K+ but the theory is that you have the main fluid running concurrently with the K+ to help decrease irritation of the vein... The K+'s primary tubing is connected into a lower port on the main line's primary tubing.

The second says you need 3 pumps... one has the main fluid, the second has the K+ (also using primary tubing) and it is connected into a port of the main fluid's tubing and the third holds the NS (also on primary tubing) which is connected into a port on the K+'s tubing. All 3 are running concurrently...

How do you do yours?

[Uptoherern, RN]

good grief..........so complicated! Your main doesn't have to be on a pump unless required by your facility. K needs to be on a pump. I would piggyback it into the port closest to the main iv bag. K can't run faster than 10 meq per hour for a peripheral, and 20 meq/hour for a central line. If it is bothering the pt., ask for an order for lidocaine to be added to the k , or just slow it down.

[traumamomtx]

put the k+ on the pump and piggy back the main iv fluids on dial-a-flow below the pump it's self so they run at the same time and decrease pain. Run K+ over and hour and only 10meq for peripheral and 20meq with central. For pain I use a warm compress at the iv site to get the vein to dilate and reduce pain; works 90% of the time. Or just run the main and K+ on a pump concurrently if the pump works that way.

[NurseyBaby'05, BSN, RN]

If it's a peripheral line, I piggy-back 10 mEq's over an hour. If the pt is not tolerating it, I slow it down. I also apply icepacks to the site. If the pt. has a central line, I run 20 mEq's over an hour. It also depends on just how low the pt's K level is and how much I have to give. If the K level is pretty low, I can't run it too slow. Often I'll try to have a PICC put in if the pt's going to be inpatient for awhile so we can preserve their veins.

[Pompom]

If it is a peripheral line it must always be mixed in 100ml/NS and run on a seperate pump. If you have a central line you could use a 50ml bag. If you are using a 100ml bag set the pump for 100cc/hr, if using a 50cc bag set the pump for 50cc/hr. I would also decrease the rate of the IVF if I was using a peripheral site so it doesn't blow the vein.

[LEVODEVO]

I work in Mass.,the feds have been getting pretty strict on giving K+,and our hospital has been quite good at following the rules...the max I have ever been able to give peripherally is a mix of 40meq of k+ in a liter of D51/2 ns or some derivative of saline..at a max rate of 60mls per hour and it must be on a pump. I work in an icu and central lines are the norm...20meqs in 50mls of ns at 100mls an hour...know what their k+ was before stating it,check the labs,don;t take someone's word....seen a lot of staff and pt's burned over this...peripheral potassium infiltrates can be horrible..i've seen plastic surgery involved,and of course lawyers...slow and dilute,i take it the pt can;t take po...kinda late for your reply but just got back in,hope it worked out..

[Haunted]

That's a whopping amount of fluid blowing thru a single lumen line! I have added lidocaine and I have also just piggied the K+. Simple is best and most of my patients have been on telemetry so we did not want to volume overload them on top of everything else.