Potassium replacement while on clear liquid diet?

AJJKRN · Feb 20, 2014

It may be true for the floor you're on but more than likely the no red or orange is to help r/o any false positives for suspected bleeding (especially in the GI tract) because of the red dyes contained in both of the colors. We don't do red or orange jello/juices/Gatorade before colonoscopy's etc.

So what's the question part about the K+ replacement have to do with the rest of your questions unless these are the colors you were told not to mix it with? Just remember the K+ is really acidic so don't pick something just as acidic to mix it with like OJ! If the Pt isn't on a clear liquid diet that is... :spit:

dudette10, MSN, RN · Feb 20, 2014

So what's the question part about the K+ replacement have to do with the rest of your questions unless these are the colors you were told not to mix it with? is...

Liquid potassium replacement PO is a powder that makes water orange.

Unless someone can think of something I am missing, I would go ahead and give it. Did your preceptor have you hold K+ replacement because of the color? In my opinion, it's not a hard and fast rule, depending on the reason for the CLD and any procedures the patient will be going for. At any rate electrolyte replacement is very important, and I would prioritize it over the "no red or orange on CLD." It's not like you're shoving cherry Popsicles down the patient's throat.

AJJKRN · Feb 20, 2014

Liquid potassium replacement PO is a powder that makes water orange.
So far the brand we have stays clear when mixed because I have been asked by the Pt to just mix it with water before...it may be orange-flavored though...different strokes for different folks, I mean med manufacturers

tokebi · Feb 20, 2014

Just remember the K+ is really acidic so don't pick something just as acidic to mix it with like OJ! If the Pt isn't on a clear liquid diet that is...

Let me make a quick correction. K+ is not acidic. Remember, acidity is a measure of the amount of protons (H+) dissociated in an aqueous solution. No H+ in K+, or KCl, which is the form in which oral K replacement comes in.

It just tastes awful, that's all.

Back to original question, I was taught no red color because if patient vomits, it can look like hematemesis. I don't know about orange though. I think it's an overkill. KCl is orange (never seen clear one yet.) I wouldn't worry about it. I think the benefit of electrolyte replacement far outweighs the remote risk.

nynursey_ · Feb 20, 2014

Ultimately, you can always check with the physician, and explain your rationale for why you asked.

nurseprnRN, BSN, RN · Feb 20, 2014

There is also no magic about the powder vs the IV potassium. Take the IV stuff, which is clear, and put it in ginger ale or something else of an acceptable color, and bottoms up.

Anna-s · Feb 21, 2014

Why wasn t it prescribed IV?

Christy1019, ASN, RN · Feb 21, 2014

There is also no magic about the powder vs the IV potassium. Take the IV stuff, which is clear, and put it in ginger ale or something else of an acceptable color, and bottoms up.

Hmm, I never knew that. Would the doses remain the same I.e. 40mEq IV = 40mEq PO? I don't know that I've ever even seen IV K+ that wasn't already mixed in a piggyback by pharmacy in my 5.5yrs as a nurse.

BD-RN, BSN, RN · Feb 22, 2014

There is also no magic about the powder vs the IV potassium. Take the IV stuff, which is clear, and put it in ginger ale or something else of an acceptable color, and bottoms up.

WHAT?! uh...no.

Pts are sometimes prescribed PO instead of IV potassium for a few reasons, some MD's believe the smaller doses of PO will actually last longer, especially the extended release horse pills. IV is more of a "quick fix" or for a larger amount of replacement, or for pts who for other reasons might need multiple replacements (oncology patients). I've seen PO potassium in pill form or in liquid form already, it's orange, in the same orange cup liquid Tylenol comes in. The potassium powder is also orange, but it's clear when it dissolves.

MY rule for clear liquids: if you can see through it, it's clear, and if it can be clear in a liquid state (jello, popsicles), it's clear.

nurseprnRN, BSN, RN · Feb 22, 2014

WHAT?! uh...no.
Pts are sometimes prescribed PO instead of IV potassium for a few reasons, some MD's believe the smaller doses of PO will actually last longer, especially the extended release horse pills. IV is more of a "quick fix" or for a larger amount of replacement, or for pts who for other reasons might need multiple replacements (oncology patients). I've seen PO potassium in pill form or in liquid form already, it's orange, in the same orange cup liquid Tylenol comes in. The potassium powder is also orange, but it's clear when it dissolves.
MY rule for clear liquids: if you can see through it, it's clear, and if it can be clear in a liquid state (jello, popsicles), it's clear.

Yes, uh, yes. This patient had potassium prescribed PO and the powdered form was specifically contraindicated for the time because its orange color might interfere with assessment of secretions or something. So the OP's question was, essentially, "Now what?"

Yes, 40mEq of KCl in the IV liquid is the same 40mEq of KCl in the powdered form. If the physician wishes potassium PO given and it must be given in a clear liquid that is not red or orange, there is no physiological reason not to put the colorless IV form in any clear liquid that makes it vaguely palatable, like ginger ale, apple juice, or chicken bouillon. This last is actually probably best because we don't normally salt sweet juices, and the bouillon is at least a basic meat flavor.

BluegrassRN · Feb 27, 2014

Our hospital rarely worries about the color of the clear liquids. If I'm concerned about a bleed, I'll limit it myself, but if there isn't any concern for an active bleed, it shouldn't make any difference.

I would have given the potassium.