Nursing Resposibilities of Patient on Kcl

8/6/2019 Nursing Resposibilities of Patient on Kcl

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POTASSIUM

POTASSIUM

POTASSIUM

POTASSIUM



HIGH ALERT MEDICATIONS

Medications that have highest risk of causing injury when misused are knownas high alert medications.

eg:- KCL, MGSO4, 50%dextrose, dopamine

hcl, dobutamine, NaHCO3.



� Protein and glycogen synthesis

� Cellular metabolism and growth

� Conducting nerve impulses

� R egulates acid base balance

� Cardiac conductionnormal range: 3.5- 5 meq/L



Serum potassium levels are primarilyregulated by kidneys. If excess or lack of potassium can cause fatal cardiacarrhythmias.



ACTION OF KCL

It is used to treat hypokalemia

( k+ <3.5meq/l)



ETIOLOGY

� Excess loss from kidney and GI tract

� Diarrhea

� Gastric suction or lavage

� Prolonged vomiting( HEG)

� Use of diuretics

� Use of certain antibiotics

� Acute alcoholism



� Muscle weakness

� Dizziness

� Hypotension

� Diarrhea� Confusion



� Leg cramps

� Polyuria

� Ecg changes( ST depression,

shallow, flat orinverted t wavesand prominent uwave)



Treatment

Oral therapy: forprophylaxis and for milddeficiency. Dosage : 16-24 meq/ day

Iv therapy: severe

deficiency and who cannottolerate oral potassium.Dosage : 40-100meq/day.



R oute of administration

Oral Iv



³DON¶T GIVE BY DIRECT IV´



�� IV intermittent therapy for urgent IV intermittent therapy for urgent Potassium replacement:Potassium replacement:

peripherally maximum 20meq/ 250ml

over 1 hr.



in central line :20meq/100ml in 1 hour.



IV InfusionsIV Infusions





Adverse Effects

GI : irritates gi tract, abdominaldiscomfort,nausea, vomiting, diarrhea.



CNS : paresthesia of limbs, flacid paralysis.



� CVS: cardiac arrythmias, cardiac arrest, postinfusion phlebitis, heart block, hypotension.





Side Effects

� Hyperkalemia

� Cardiac arrest

� Thrombophlebitis

� Extravasation





Serum k + >5.5meq/l

Etiology :

� increased k intake

� Decreased k excretion

� Tubular unresposiveness to aldosterone

� R edistribution of k+ in extra cellular space

� Untreated addisons disease



Signs and symptoms

� Palpitation

� Skipped heart beats.

� Ecg changes: tall t wave, widened

qrs complex, prolonged PR interval,flat p wave.

� Numbness of hand and feet.

� Dyspnea

� Anxiety



Diagnosis

� Lab value

Serum k+ > 5.5 meq/l



Treatment

� Abnormal ECGyes

calcium

gluconate

� Continuous ECG monitoring

� Hyperglycemia insulin



No

Administer insulin and glucose

Consider albuterol

Consider sodium bicarbonate



Give exchange resin or consider hemodialysis

� Follow k+ result until k + <5.5meq/L.



Contra indication

patients with severe renal impairment

oliguria,

anuria,

acute dehydration,

heat cramps,

hyperkalemia.







Nursing considerations

� Teach the patient howto prepare the powderand how to take drugs.

� Tell patient to take itwith or after meals withfull glass of water orfruit juice to decrease

GI irritation.



� Discuss dietary source of k: vegetables like potato,carrots, mushroom,beans , tomato, spinach,etc.

� Fruits: dates, orange,pear, raisins, banana etc.

� Meat: chicken, beef andveal meat.



� Teach the signs and symptoms of hyperkalemia,

report any discomfort at iv site.

� Warn not to use salt substitute without prescription.

� Monitor serum electrolyte frequently.� ECG monitoring and observe for any changes.



� Jowaher Abdulla Abdullaziz Harby, PG,9 wks

with HEG, serum k+ is 2.7 meq/L. Urineketone is +++. MSOD ordered inj.kcl60meq/24 hrs in 3L R L/NS alternatively.



CALCULATION





� KCL= 60 meq/24hrs.

� So for 1hr = 60/24= 2.5meq/hr.

� One IV bottle is 500ml, that is for 4 hrs.

� So in each bottle, 2.5

*

4= 10meq of KCL

should be added.



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Nursing Resposibilities of Patient on Kcl