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IV fluid question

Posted
ryand15 ryand15 (New) New

Hey everyone, I'm a nursing student and I was preplanning on a patient and I need a little help with his IVF's.

I have a patient with acute pancreatitis and he is on normal saline with 20 kcl at 50ml/hr. My questions are:

1. Which type of fluid is this? I know NS is isotonic does adding the kcl change it?

2. Why would my patient be getting this fluid if his potassium has been normal the whole admission. Would it be preventive because he is on Lasix?

1) Not enough to matter

2) Yes, good thinking. Also, if he is getting insulin for elevated blood sugars, that tends to drive K+ into cells, thus lowering serum K+.

Alright so it still is isotonic.

And he gets insulin too, so that makes a lot more sense now.

Thanks so much!

This is the pre-nursing board, I would ask the nursing board :) Good luck.

If the patient is on Lasix, doctors will prescribe KCL IV fluids. Lasix is a diuretic and when fluid is being released out of the body, the potassium level decreases along with it. Side effect of Lasix are hypotension, hyperglycemia, GI upset, weakness and HYPOKALEMIA. Are you provided with the lab values? As a nursing consideration, when lasix is administered you are supposed to monitor for the potassium level.

hodgieRN

Specializes in ER trauma, ICU - trauma, neuro surgical. Has 10 years experience.

KCL does not change the tonicity of of IV fluids. It is an isotonic fluid (normal saline) with simply electrolytes added. Adding dextrose changes the tonicity and changing the sodium content changes the tonicity. Dextrose makes it hypertonic (D5 normal saline, D5 1/2 NS, D5 LR), (except D5 water, which is isotonic in the bag but becomes hypotonic after the dextrose is metabolized). If no dextrose is added, a reduction of sodium (like 1/2 normal saline) is hypotonic. Any electrolyte (magnesium, calcium, phosphorus, potassium) just helps correct the lab values. The are fluids such as 3% saline (which is VERY hypertonic). Normal saline has a content of 0.9%, so 3% greatly increases the tonicity.

Look at the osmolarity on the bag. Our normal osmolarity in the body is 275-295. If the osmo is greater than 295, it is hypertonic. If it below, then it is hypotonic.

If the pt is on lasix, then yes, they need constant potassium replacement. Lasix will make you urinate potassium like crazy. But, pancreatitis itslef can cause all sort of issues, include major shifts or loss in electrolytes. The pancreas auto-digests itself and all the digestive enzymes go nuts. Many abdominal pts require IV fluids with KCL in general. It is a nasty disease process. It can cause severe dehydration, blood loss (another reason for KCL because one of the ways you become hypokalemic is acute blood loss), ascites, and massive capillary leak. Many pts not only lose potassium, but they lose calcium and magnesium as well. Once the digestive enzymes eat the pancreas, they start eating at the rest of the organs. The whole area can go necrotic.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

Hey everyone, I'm a nursing student and I was preplanning on a patient and I need a little help with his IVF's.

I have a patient with acute pancreatitis and he is on normal saline with 20 kcl at 50ml/hr. My questions are:

1. Which type of fluid is this? I know NS is isotonic does adding the kcl change it?

2. Why would my patient be getting this fluid if his potassium has been normal the whole admission. Would it be preventive because he is on Lasix?

Besides being on lasix is this patient vomiting? Are they NPO?

blondy2061h, MSN, RN

Specializes in Oncology. Has 15 years experience.

Holy cow, a nursing student question where they thought for themselves, got as far as they could, and just needed a little help. Good job!

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

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