so much hypokalaemia?

[sister s]

G'day all.

Can anyone tell me why so many ICU patients need potassium infusions going? Is the missing potassium being used, or stored in the cells?

Thanks for any help :paw:

[Chisca, RN]

The renal patients are stealing it.

[pricklypear]

The renal patients are stealing it.

:yeah:ROLF

But seriously, I think it's just the nature of the critical-care patient. It's a symptom of many of the things ICU patients suffer from: vomiting, diarrhea, renal/organ failure, injury, surgery, other electrolyte imbalances, hyper/hypo glycemia, respiratory failure. It's not hiding, it's just not there.

[ghillbert, MSN, NP]

Not to mention, we love using diuretics in ICU.

[stressgal, RN]

Not to mention, we love using diuretics in ICU.

Yep!

Here's my question.......

In my facility we are constantly hanging k+ riders on our folks for replacement. It was my understanding that if the gut works, use the gut and po potassium was utilized better. Not to mention we place someone on a lasix drip, attempting to diurese then hang a huge k+rider to replace potassium. Should we not first look at using liquid po via an NG if capsule/tablet is not an option? Is it just easier for the doc to write ---Meq K+ rider? I do realize that patient's on diuretics put out much more fluids than we are putting in with a k+ rider, yet when we are limiting their total fluid input I feel as if we are chasing our tails. Just wondering how it's done elsewhere.

[tri-rn]

The renal patients are stealing it.

[ayla2004, ASN, RN]

not an icu nurse but we use k+ infusion depeninging on the severity of the hypokalemia and Sando-k(Uk brand ) a po med for 3 day course the rest of the time. Sando-k is a effervest tablet ideal for a ng tube.

[getoverit, BSN, RN, EMT-P]

Yep!

Here's my question.......

In my facility we are constantly hanging k+ riders on our folks for replacement. It was my understanding that if the gut works, use the gut and po potassium was utilized better. Not to mention we place someone on a lasix drip, attempting to diurese then hang a huge k+rider to replace potassium. Should we not first look at using liquid po via an NG if capsule/tablet is not an option? Is it just easier for the doc to write ---Meq K+ rider? I do realize that patient's on diuretics put out much more fluids than we are putting in with a k+ rider, yet when we are limiting their total fluid input I feel as if we are chasing our tails. Just wondering how it's done elsewhere.

Hey, happens everywhere. My understanding of the gut and po K+ is the same as yours, we just had a bedside discussion about that a couple hours ago.

It shouldn't be easier for the doc to write a ivpb order than po. In fact, most of the time our K+ supplement orders say ivpb or po and I"ll give both, like a 40 meq via ngt and hang a 20 meq rider over 2 hrs if the patient is very hypokalemic and the MD wants another chemistry panel drawn in a couple hours. Sometimes we consider other forms of diuretics to spare the K+. But then again, there are plenty of times where we've ended up giving close to 500cc of fluid in 24 hrs with just the K+ riders!! It's a toss-up.

[athena55, BSN, RN]

Think it also depends (which to use, IVPB or PO) how symptomatic your patient is (how low is the K+), and the underlying problem/disease process