Why would a nurse push IV potassium?

[Nsco2018]

I saw a post on fb earlier by a pt who's in the hospital for DKA. Says they are being pushed potassium. Granted I'm still a student, but I thought this was totally a no no.

[mtmkjr, BSN]

I would just ask what they mean by "pushed".

I don't think it's typical for a non medical person to talk about pushing meds the way that we do. More likely they simply mean pushing potassium in the same way you might push fluids for a sick toddler to prevent dehydration.

[/username, BSN, RN]

To stop their patient's heart....

[nalie2, ADN, BSN, MSN, RN, NP]

This reminds me of something my instructor said in nursing school...Unless you're in San Quentin State Prison you shouldn't push potassium.

[Ruby Vee, BSN]

Ruixi13 said:

OMG that's some messed up ****... I couldn't even imagine being the nurse who receives mislabeled syringes like that and administering it.. >_

I was one of the nurses who received the mislabeled syringes. It wasn't my fault. It wasn't the fault of the other nurses who flushed with KCl. But that was a hard one to get over.

[mantidqueen1]

My nursing instructor always said they only IV push potassium in Texas.

[chare]

mantidqueen1 said:

My nursing instructor always said they only IV push potassium in Texas.

And your point is?

[bgxyrnf, MSN, RN]

Nsco2018 said:

I saw a post on fb earlier by a pt who's in the hospital for DKA. Says they are being pushed potassium. Granted I'm still a student, but I thought this was totally a no no.

The only two reasons that I can of why a nurse would push IV potassium...

1) The nurse is grossly incompetent and unable to read simple orders, or

2) The nurse is actively intending to kill the patient.

In this case, I'm quite certain that the error is not on the part of the nurse but rather on the part of the patient who doesn't understand the meaning of IV push.

[Rose_Queen, BSN, MSN, RN]

~♪♫ in my ♥~ said:

The only two reasons that I can of why a nurse would push IV potassium...

1) The nurse is grossly incompetent and unable to read simple orders, or

2) The nurse is actively intending to kill the patient.

In this case, I'm quite certain that the error is not on the part of the nurse but rather on the part of the patient who doesn't understand the meaning of IV push.

3. Cardiac surgery, if that nurse happens to have also pursued perfusion education and licensing. I work with a perfusionist who also still holds a nursing license. He pushes potassium fairly rapidly right into the left and right coronary arteries at least once a day. (I love seeing the looks on some nurses' faces when I casually mention grabbing a vial of 40mEq of potassium and it's given in a matter of maybe a minute- just because they don't realize that in cardiac surgery, we do indeed fully stop the heart in many cases).

But as the patient in the OP was able to talk and post on Facebook, said patient clearly is not receiving any kind of potassium IV push.

[offlabel]

Is 1 to 2 meq/min considered "push"? I do that on a pump only because standing there with a syringe is too much of a hassle. And my patients don't die and I'm not in Texas.

[blondy2061h, MSN, RN]

You know how when people are sick or exercising or it's a hot day they say they need to "push fluids." They mean they need to take in a lot of fluids so they don't become dehydrated or because they're already dehydrated. They don't mean they're literally getting iv push fluids.

I'm guessing this lay person took that expression and used it in this scenario to mean she's defiant in potassium and they're having to give it to her frequently.

[cleback]

Ruby Vee said:

And another time long, long ago, in another hospital far, far away, the Pharmacy drew up all of our central line flush syringes, labeled them and sent them to the floor in bags of 10 each. After a couple of patients coded while their central lines were being flushed, the flush syringes were sent for analysis. As it turned out, each 10cc syringe contained 20 mEq of KCl. One patient who lived through it told me that she felt her face flush, and it "got all prickly feeling. And I tasted salt."

Yikes. Sounds like a Charlie Cullen of the pharmacy world.

[NuGuyNurse2b]

chare said:

And your point is?

There was none, she was making a joke, which clearly went over your head.