Mg and K

In the ICUs at my facility we have a nurse-driven protocol for supplementation of most electrolytes (K, Mg, Ca, Phos). The goal in each protocol is to maintain the patient around the mid to upper end of normal for most electrolytes. RNs will supplement as needed for the protocol and only call the provider when the patient does not responding to supplementation appropriately, requires excessive doses of a particular electrolyte, or is symptomatic and warrants faster replacement than the protocol etc.

Some patients who come from CVICU have PRN orders like that. For example, if potassium is below 3.5 give blah blah blah. If potassium if between 3.5 to 3.9 give blah blah blah. There are PRN orders for peripheral and central line infusions because SOMETIMES they come with central lines. Sometimes midlines or PICCs. But btw only certain surgeons do this for CABG patients. There also PRN lab orders such as redraw Magnesium 3 hours after replacement.

Some surgeons/doctors care about the numbers and will cover a Mag of 1.9, just because they like it yo he abobe 2.0....others won't cover it if the patient is asymptomatic and only has rare ectopy.