Post-op IV administration

Published

I was given this question on a fluid and electrolyte take home quiz and I have no idea how to find the answer. Can someone help me?

Question: Post-op orders are D51/2NS with 40 mEq/L of KCL. The liter of Lactated Ringers solution that is hanging has not completely infused. What will the nurse do?

a. Finish the current liter of fluid.

b. Ask the client if he needs to void.

c. Hang the ordered IV.

d. Assess the IV site.

I'm leaning towards "c." just because Lactated Ringer's if isontonic and therefore should not adversely affect the infusion of a hypertonic solution.

Any thoughts?

Up Vote Up Vote ×
Specializes in Critical Care.
I was given this question on a fluid and electrolyte take home quiz and I have no idea how to find the answer. Can someone help me?

Question: Post-op orders are D51/2NS with 40 mEq/L of KCL. The liter of Lactated Ringers solution that is hanging has not completely infused. What will the nurse do?

a. Finish the current liter of fluid.

b. Ask the client if he needs to void.

c. Hang the ordered IV.

d. Assess the IV site.

I'm leaning towards "c." just because Lactated Ringer's if isontonic and therefore should not adversely affect the infusion of a hypertonic solution.

Any thoughts?

If I had this on the test, I'd probably answer "C" as well- the client is likely in need of a small amount of nutrients (D5) and even isotonic fluids strip K.

In reality, it'd depend on how much LR is left in the bag and waiting for pharmacy to send up the new one (most hospitals don't keep bags with K added in the general floor stock).

Up Vote Up Vote ×
Specializes in med/surg, telemetry, IV therapy, mgmt.

Hang the ordered IV. See this Table of Commonly Used IV Solutions.doc (you can print it out if you would like). You will see on this table that Lactated Ringer's solution only contains 4 mEq of Potassium and only provides 9 calories per liter. 5% Dextrose is going to give this patient more calories and potassium. Lactated Ringer's is not a good maintenance solution as it does not supply enough replacement electrolytes. Actually, the one action that should be done that is not listed is that the nurse should check the patient's most recent electrolyte results.

Up Vote Up Vote ×
If I had this on the test, I'd probably answer "C" as well- the client is likely in need of a small amount of nutrients (D5) and even isotonic fluids strip K.

In reality, it'd depend on how much LR is left in the bag and waiting for pharmacy to send up the new one (most hospitals don't keep bags with K added in the general floor stock).

I thought this was the answer but guess what I just read in Potter and Perry. "The nurse should verify that the client has adequrine output before administering an IV solution containing potassium, because hyperkalemia can quickly develop."

Up Vote Up Vote ×
Hang the ordered IV. See this Table of Commonly Used IV Solutions.doc (you can print it out if you would like). You will see on this table that Lactated Ringer's solution only contains 4 mEq of Potassium and only provides 9 calories per liter. 5% Dextrose is going to give this patient more calories and potassium. Lactated Ringer's is not a good maintenance solution as it does not supply enough replacement electrolytes. Actually, the one action that should be done that is not listed is that the nurse should check the patient's most recent electrolyte results.

Thank you very much for that document. It's very useful. I just thought that I would share with you something I just found in Potter and Perry. " The nurse should verify that the client has adequate urine output before administering an IV solution containing potassium, because hyperkalemia can develop quickly."

Up Vote Up Vote ×
Specializes in med/surg, telemetry, IV therapy, mgmt.
Thank you very much for that document. It's very useful. I just thought that I would share with you something I just found in Potter and Perry. " The nurse should verify that the client has adequate urine output before administering an IV solution containing potassium, because hyperkalemia can develop quickly."

But that is not one of your answer choices. Asking the client if he needs to void is not the same as verifying that the client has adequate urine output. Verify that the client has adequate urine output is measuring intake and output, right?

Up Vote Up Vote ×
Specializes in Critical Care.
I thought this was the answer but guess what I just read in Potter and Perry. "The nurse should verify that the client has adequrine output before administering an IV solution containing potassium, because hyperkalemia can quickly develop."

"Ask the client if he needs to void" isn't exactly the same as assessing for adequate kidney function-- especially in a patient who has likely been NPO for 8-12 hours pre-procedure.

Up Vote Up Vote ×

You have a good point.

Up Vote Up Vote ×

I will definitely take that into consideration.:nuke:

Up Vote Up Vote ×

It is interesting that you all are talking about that question. I do not think that it is worded well but I think that the answer is the one about voiding first.

Check out the link

http://74.125.95.132/search?q=cache:GTioZrjUd_8J:dermatlas.med.jhmi.edu/ppp/PEDIATRIC%2520GENERAL%2520CARE%252FPEDS%2520Potassium%2520protocol%25207-07.doc+first+void+pre+potassium+iv&cd=1&hl=en&ct=clnk&gl=us

I am at the hospital now in clinical and was looking up your topic because I didn't know the answer and my nursing instructor told me to look it up.

Up Vote Up Vote ×
Specializes in critical care, PACU.

in exam world: hang the rx'd bag

in the real world: run whats left until you transfer the patient from PACU to the floor so that way you dont waste

Up Vote Up Vote ×
Specializes in IMCU.

Why not assess? If you are going to hang a new solution you would need to assess first. If you wanted the existing solution to go in first you would still assess.

Then again I just woke up :)

Love to know the "correct answer".

Up Vote Up Vote ×
+ Join the Discussion