KlamsterRN

Also, insulin is NOT the transport to K into a cell! Insulin is the hormone that finds to a receptor to allow glucose (carbon, which is needed in glycolysis to make ATP) to enter the cell. The resultant ATP attaches to the NA/K pump which allows 3 sodium to exit the cell and 2 potassium to enter the cell. Please research just a tiny bit before posting opinions. This is what decreases your serum or extra cellular K. Also, glucose alone would draw potassium out of the cell, so giving d50 then the vein blowing will also harm your patient....

D50 is NOT GIVEN TO PREVENT HYPOGLYCEMIA!!!!!!!!!! People who do NOT know for a fact should stop misleading other nurses... It's not safe. Reference the 2013 update to this article: https://allnurses.com/emergency-nursing/hyperkalemia-order-meds-520208-page2.html

I know this post is really old, but here's my 2 cents from the icu perspective. (From a trauma I major university hospital). In an emergent situation, give calcium first, followed by d50/regular insulin: usually 1amp to 10 units. IV insulin has an onset of minutes whereas glucose has an onset of Its been said in here to give glucose first in case you lose access... This is false sense of security : "Do not give glucose alone as hyperosmolarity can shift potassium out of cells."(reference 3) And you could end up with a higher K than when you started, which is bad for the heart, the body's life organ. While giving insulin IV alone has its downside, so does the faster onset d50. If in doubt about access because you only have one 22g that has been in for days, I would mix the regular insulin in the d50 and give TOGETHER. as far as the mechanism, there are mixed comments in here.the correct answer is this: in a normal patient, k+ is intracellular and Na+ is extracellular. When the serum k+ is elevated, it is because there is an increased amount of K+ outside of the cell. This can be caused from CRF or ARF, burns, crush injuries, or even the use of too much potassium salts (cardiac patients on a low Na+ diet). Insulin isn't to prevent the patients blood sugar from elevating or d50 from falling, both incorrect conclusions. The correct answer is insulin moves glucose into the cell, which then draws in the potassium. The insulin hormone binds to an insulin receptor on the cell membrane which allows the cell to be open for glucose to enter. (When insulin is low, glu can't enter the cell, which gives you high serum blood sugar). The cell needs glucose (carbon) for ATP which attaches to the Na/K pump on the incide if the cell and allows the 3 sodium to exit and 2 potassium to enter the cell. To show th validity of this post, here are a few resources 1. http://www.eric.vcu.edu/home/resources/consults/Hyperkalemia.pdf 2. http://www.austincc.edu/apreview/EmphasisItems/Glucose_regulation.html 3. http://www.eric.vcu.edu/home/resources/consults/Hyperkalemia.pdf