milkpumba

Just got home from the weirdest shift I've had ever. I work in a long term care facility and one of my patients has been presenting with signs of dehydration. Yesterday, this same patient had an infusion of 1000ml NS bolus as per the doctor's orders. So today, I tried to check her BP but couldn't get a reading with a manual or electronic one. I informed the physician and received orders to transfer the patient to emerg. When EMS came, they were able to get a reading via their own electronic cuff. It was 130/79. I felt so stupid at the time LOL. But they also tried to take the BP manually and couldn't hear anything. In the end the physician and family decided to still send her to emerg. This is a first time for me, what are you're thoughts??

The monograph states that it is to run for over an hour in a 100mL - 1000mL of any commonly used IV solution.

I've already used this and found no interactions between Potassium vs Multi1000 (Vitamins, multiple). Also, the monograph states that Multi1000 is compatible with any commonly used IV solution, which the KCL bag also has (D5W and 0.45% Sodium chloride), so I'm kind of leaning to piggybacking it on the KCL primary

Normal range for potassium is 3.3-5.1 Potassium is in a primary bag with D5W and 0.45% Sodium chloride (KCL20 mmol/L D5W 0.45% Sodium Chloride that is to infuse at a rate of 75 mL/hr)

I think that I can piggyback it on either but it is better to piggyback it on the primary line that has KCL since the patient's potassium is not that low yet, and he does not really need the potassium stat, rather than the LR which he needs right away because of risk of dehydration.

So I have final scenario coming up in a couple of days. In the scenario, the patient has two peripheral lines: 1. KCL20 mmol/L D5W 0.45% Sodium Chloride that should infuse at 75 mL/hr and 2. Ringers Lactate continuous IV infusion for gastric loss replacement. Multi-1000 IVPB (Vitamins, multiple) should also be administered. I'm not sure where to piggyback the Multi1000, should I piggyback on KCL or LR? Why? Also, the patient has an order for gastric loss replacement of 1:1/2, latest gastric loss is 1675 mL. Lab values are: Potassium 3.0 Sodium 116 Chloride 99 Thanks so much!