Low potassium level, post CABG patient

We had a post CABG patient when I was on a tile floor (I'm a student) and his potassium was 3.2. He had potassium chloride running and the nurse told me we were just going to continue monitoring him because the level wasn't in the danger zone. If I came across this situation again, is there anything I could do differently? I have to write a reflective journal and need to come up with 3 things I could do differently in a similar situation. I really am not sure what I could do.

Thanks guys.

That depends on the patient. The facility. The surgeons/cardiology. The monitor. Generally speaking...cardiac patients will have their K levels on the higher side of normal......IF their renal function is normal.

You have a heart that has been stopped, started, man-handled, cut, sewed upon, frozen ....which makes it pretty IRRITABLE. The hearts tolerance for everyday annoyances is pretty low so..... A low potassium can cause myocardial irritability. In this setting the heart is pretty irritable already so any disturbance can cause arrhythmias.

When you are the primary nurse......check the patients chart for past labs. Check if there are any standing orders for K. Is this pt prone for arrhythmias? What is the renal status? are the getting diuretics routinely? How fast is the IVF infusing? Are they any oral supplements being given? What are the trending lytes showing? Depending on these factors I would either call the MD or wait to let him know on rounds.

As a student the first thing you could have done differently is speak with your instructor. An extremely important step for you, your patient and your instructor. If you are remaining on that unit get a copy of their K+ replacement protocols. Know where to find that and other similar information quickly within their system.

As a student you won't know the experience level of the nurse you are speaking with. Nor will you know if they are the nurse who is diligent with protocols or slightly less so. They may be newer to the unit.

You could still discuss this with your instructor and ask him or her the same question you are asking us. They may remember the patient details too.

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