Some icus use an nursedriven electrolyte replacement protocol. We aim to combine the potassium and the glucose algorithm in the future. Aha guidelines and statements circulation cme information for. Potassium replacement protocol intravenous recommended rate of infusion is 10 meqh. If creatinine greater than 2 mgdl andor documentation of renal failure or dialysis, contact physician for specific replacement orders. University of michigan healthsystem adult intensive care. The primary objective was to evaluate the efficacy of the electrolyte repletion protocol by. The electrolyte replacement protocols, calcium chloride level i areas only or calcium gluconate all levels of care, magnesium sulfate, potassium chloride, or potassium phosphate, may be ordered individually or in combination.
The different settings could include home with outpatient therapy, home with home. Fluid and electrolyte management billie bartel and elizabeth gau le a r n i n g objectives 1. Potassium chloride is the most widely administered salt, as, in most patients. Implementation and evaluation of a nursecentered computerized. Interim lsu public hospital adult electrolyte replacement. Standard potassium and magnesium replacement protocol. Calcium andor phosphorus replacement needs to be ordered individually as required low dose potassium replacement protocol intravenous recommended rate of infusion is 10 meqhr. Glucoseinsulin shifts k into cells, duration 46 hours d.
Side effects requiring immediate medical attention. After a total knee replacement, you will definitely need physical therapy. Potassium chloride kcl is the most suitable salt for repletion of the common forms. The use of a potassium replacement protocol can improve potassium regulation. Significant electrolyte depletion can result in serious complications for patients.
An electrolyte is a substance that produces an electrically conducting solution when dissolved. Effects of electrolyte replacement protocol implementation. Along with its needed effects, electrolyte replacement solutions may cause some unwanted effects. Lifethreatening electrolyte abnormalities circulation. The kidney accomplishes this by altering urine volume and osmolarity. Although not all of these side effects may occur, if. Protocol electrolyte protocol x electrolyte protocol x electrolyte replacement protocol. Doctors give unbiased, helpful information on indications, contraindications, benefits, and complications.
Beta2agonists shifts k into cells, duration 2 hours e. Electrolyte replacement practice management guideline. Calcium gluconate peripheralcalcium chloride central stabilizes cardiac membrane b. Nutrition journal of parenteral and enteral american society for. Identify and understand basic fluid and electrolyte abnormalities in critically ill patients. Correction 70kg use adjusted body weight for obese pts 2. Electrolyte guideline all patients with chronic kidney disease scr greater than 2. Regulation of potassium in the intensive care unit icu requires potassium administration with frequent blood potassium measurements and subsequent adjustments of the amount of potassium administrated.
The setting will depend on your general health and other medical comorbidities. Pedsap 2018 book 2 fluids, electrolytes, and nutrition. If serum magnesium johns hopkins hospital, johns hopkins bayview medical center or johns hopkins community physicians. A prospective study from saudi arabia comparing protocoldriven and physiciandriven electrolyte replacement of potassium, magnesium, and phosphate in critically ill adult patients reported that protocoldriven replacement was associated with more timely administration of the replacement dose and fewer missed episodes of low levels without any. Electrolytes replacement protocol answers on healthtap. Evaluation of an electrolyte repletion protocol for. Evaluation of an electrolyte replacement protocol in an. Critical care icupcu rn to order specific medication needed based on lab result.
Guidelines for electrolyte replacement intravenous potassium replacement recommendations for patients with normal renal function serum potassium recommended iv recommended meql kcl supplementation followup monitoring 3. The electrolyte replacement protocols, calcium chloride level i areas only or calcium gluconate all levels of care, magnesium sulfate. The electrolyte replacement protocols, magnesium sulfate, or potassium chloride, may be ordered individually or in combination. Differentiate between the types of fluids used for fluid replacement in different disease states. Measurement of electrolytes is a commonly performed diagnostic procedure. Potassium disorders can cause major complications and must be avoided in critically ill patients. Bedside nurses were responsible for following the protocol and for preparing and administering the electrolyte replacement doses. Permanent patient record patient identificaltion critical care protocol electrolyte replacement date time potassium replacement 1. Clinical features cns symptoms sodium pdf ann saudi med 252 marchapril 2005. When indicated, the maximum amount of iv potassium replacement. Electrolyte replacement orders lsu school of medicine. Exchange resins eg kayexalate po dose takes effect in 1. In medicine, electrolyte replacement is needed when a person has prolonged vomiting or. Potassium chloride an overview sciencedirect topics.
Select the column with the corresponding serum elec trolyte serum sodium 3. If there is a replacement dose for acute and maintenance electrolytes, both guidelines are included. Magnesium sulfate electrolyte replacement protocols have been established and are used to prevent. Eirmc hospitalist service electrolytes to be assessed and appropriate correction administered as follows with every electrolyte panel not to be used for patients 0. Serum ph protocol or policy, nor are intended to replace clinical judgment or dictate care of individual patients.
We hypothesized that a protocol would reduce the time of replacement dose administration and increase provider satisfaction with the process of electrolyte replacement. Renal insufficiency scr 2 andor crcl replacement if gi tract available oralenteral replacement is preferred in asymptomatic patients. Sodium bicarbonate shifts k into cells, duration 2 hours, less efficacious than insulinalbuterol c. Electrolyte replacement practice management guidelines. Electrolyte replacement critical care icupcu 30400716. Intravenous electrolyte replacement can produce lifethreatening complications, serious arrhythmias and phlebitis. Content on this page has not been checked for accuracy. Pdf the intensive care unit is a dynamic environment, where high numbers of. In some cases therapy for lifethreatening electrolyte disorders.
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