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Discussion

Medication question

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

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I work in a peds unit. We do not add K unless the child has voided a decent amount.

mea culpa....

just called our peds unit and they too also check to make sure kids pee before first before giving KCL.

no, they don't always do an EKG (it depends)

Sometimes they monitor continuously if K is low and it is warranted.

Thank you for the enlightenment and for teaching me something.

Took me 2 days and 4 posts but i learned something today.

and gwenith, yes adult critical care.

Hey EastCoast, thanks for searching out the answer:). And you know what??? If I need critical care, I want to have you or a nurse like you taking care of me:D!

  • Experts

No problem Eastcoast and Kudos for taking it so well. This is one of those areas where the knowledge does not automatically translate. This has been a good thread because for everyone who answered there were at least three who read and learnt.

Once again kudos in showing that there is nothing wrong with learning something new.

So is that it? Is voiding the answer? It makes sense but being an LPN we didnt get that in depth and I was thinking cardiac as well. I like these kinds of posts forces one to think and good for those of us trying slow as maybe to advance our education. You all are awsome for that.

I think it was a good post as well. If I feel strongly enough about an answer when I hear a different view I will look to try to find out what the right answer is. It's engaging dialogue and came with supportive reasoning which is so much better that being force fed info and not having opportunity to process and reason through the answers. Tho it may information that i might never use, we do have peds and occassionally i am on that unit so I will look a bit brighter on my next visit.

gwenith and brownie Thanks for not saying 'nahnahnahnahnahnah...told ya so!!!'

oh and wise bear....have you just sat quietly by and watched this thread grow?

EastCoast you're welcome, but it never entered my mind. You were excellent in your reasoning, and if this hadn't been a peds question, I probably would've went along with you:D

Well, I just 'sat here and watched this thread grow' lol, but, as with several others I learned some new things. I'm pretty new to this bb, but I enjoy this kind of dialogue! Like everyone's attitude!

My guess would be the ability to void.

pee and ECG were my thoughts...ya know...being a cardiac nurse and all. :D

  • Author

Wow! What a discussion. I didn't know the answer for sure, that is why i posted it. I am a surgical nurse. In the past I worked Pediatric ICU. I have worked in pediatric Hospitals in surgery. I still enjoy helping to close a few Patent Ductus up on the NICU.

This question threw me. All of the basic reasonings that ran thru this thread also ran thru my brain, yet nothing was strong enough to satisfy me. I left it blank on a Med test that was given by a new employer. I will ask Tommorrow for the answer that was expected. After reading all the threads and having minimal exposure to the Vast and complicated arena of Pediatric Critical Care. I am going to throw my weight behind making sure that the patient is voiding. I WILL RETURN LATER WITH THE TEST ANSWER.

YOU GUYS REALLY ROCK!

  • Experts

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.

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