nurse caring for an eight year old with gastroenteritis she is to add kcl to the iv. which of the following signs would be critical for the nurse to assess prior to adding kcl. a. independant bowel movements b. a baseline ekg c.ability to void d. active bowel sounds.
i have moved the thread from nursing issues to here as not a lot of pediatric nurses have responded on the thread yet and i thought it would be valuable if we had more input from that specialty
Specializes in NICU, PICU, PCVICU and peds oncology.
over and over and over, orders on my peds icu patients would read:
add 20 mmol kcl/l to iv maintenance once urine output established.
let's face it, unless the kcl concentration of an iv fluid is very high, the risk of inducing hyperkalemia in a patient with normal renal function is pretty low. rapid treatment of hyperkalemia using a d25w bolus and insulin is used in most icus.
in our unit, where so many of our patients are post op cv surgery, we often run kcl 1:1 infusions... 5 mmol kcl to 5 ml ns... for very low serum k+ levels. the first time i ran one, my anxiety level was pretty high, but it's old hat now.
I am a new grad and I actually saw this question several times on tests and on the NCLEX. The answer should be verifying that the kiddo has urinated. I think everyone knows this now, judging by all the replies- I just thought I would add in my 2 cents.:)
Yes, it WAS great dialogue, and I, too, hope to see more of this kind on here, as we all have much to learn from one another. :)
I think much of my support of the voiding concept is due to my background in dialysis as well as still being pretty much a new grad, and remember well the constant impressing on my memory the importance of renal function and/or ability to void before adding K+... also remember quizzes and even NCLEX having a question on this subject.
Not to minimize the importance of the cardiac issues by ANY means, but the simple manner in which this question was phrased, and getting that "which one FIRST" feeling from the question, just led me to to believe this was the answer they were looking for.
Loved hearing all the responses and the critical thinking in progress here ! Good work !
I did not get the JOB that I took the test with, I gotta another contract with a different agency. i have not had the chance to get back with the testing agency as yet and since my other job was not on the line i sorta let the question go. I am now writing myself a note so i will remember to call them as soon as I arrive home 4: 30p tommorrow. If I do not call right away it will be too
late for another day. please be and thank you for being Patient.
Since the question reads as follows "which of the following SIGNS would be crticial for the nurse to assess" I will have to go with C. Ability to void.
I just looked this up in the drug guide. Nowhere do I see anything stating pt must void, but I do see numerous references to watching for ECG changes. But, to be fair, it says nothing about acquiring a base ECG. So I'm sticking with B.
I suggest we bombard wiseRN with PMs if she does not give us the answer soon.
NotReady4PrimeTime, RN
5 Articles; 7,358 Posts
over and over and over, orders on my peds icu patients would read:
add 20 mmol kcl/l to iv maintenance once urine output established.
let's face it, unless the kcl concentration of an iv fluid is very high, the risk of inducing hyperkalemia in a patient with normal renal function is pretty low. rapid treatment of hyperkalemia using a d25w bolus and insulin is used in most icus.
in our unit, where so many of our patients are post op cv surgery, we often run kcl 1:1 infusions... 5 mmol kcl to 5 ml ns... for very low serum k+ levels. the first time i ran one, my anxiety level was pretty high, but it's old hat now.