Calcium gluconate peripheralcalcium chloride central stabilizes cardiac membrane b. Doctors give unbiased, helpful information on indications, contraindications, benefits, and complications. Effects of electrolyte replacement protocol implementation. Evaluation of an electrolyte replacement protocol in an. 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. In some cases therapy for lifethreatening electrolyte disorders.
Along with its needed effects, electrolyte replacement solutions may cause some unwanted effects. 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. After a total knee replacement, you will definitely need physical therapy. 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. Clinical features cns symptoms sodium pdf ann saudi med 252 marchapril 2005. Content on this page has not been checked for accuracy. Protocol electrolyte protocol x electrolyte protocol x electrolyte replacement protocol. Select the column with the corresponding serum elec trolyte serum sodium 3. Interim lsu public hospital adult electrolyte replacement. Iv potassium replacement varies from one patient to another. Eirmc hospitalist service electrolytes to be assessed and appropriate correction administered as follows with every electrolyte panel not to be used for patients 0. Electrolyte guideline all patients with chronic kidney disease scr greater than 2.
Potassium chloride kcl is the most suitable salt for repletion of the common forms. Evaluation of an electrolyte repletion protocol for. Electrolyte replacement practice management guideline. Some icus use an nursedriven electrolyte replacement protocol. Correction 70kg use adjusted body weight for obese pts 2. All of the electrolyte guidelines are similar in the manner they work. Potassium chloride an overview sciencedirect topics. An electrolyte is a substance that produces an electrically conducting solution when dissolved. If there is a replacement dose for acute and maintenance electrolytes, both guidelines are included. The kidney accomplishes this by altering urine volume and osmolarity. Electrolyte replacement critical care icupcu 30400716. Bedside nurses were responsible for following the protocol and for preparing and administering the electrolyte replacement doses. The different settings could include home with outpatient therapy, home with home.
Potassium chloride is the most widely administered salt, as, in most patients. Critical care icupcu rn to order specific medication needed based on lab result. Differentiate between the types of fluids used for fluid replacement in different disease states. Side effects requiring immediate medical attention. Although not all of these side effects may occur, if. Renal insufficiency scr 2 andor crcl replacement if gi tract available oralenteral replacement is preferred in asymptomatic patients. The electrolyte replacement protocols, magnesium sulfate, or potassium chloride, may be ordered individually or in combination. Implementation and evaluation of a nursecentered computerized. We hypothesized that a protocol would reduce the time of replacement dose administration and increase provider satisfaction with the process of electrolyte replacement. Identify and understand basic fluid and electrolyte abnormalities in critically ill patients. Pdf the intensive care unit is a dynamic environment, where high numbers of.
Aha guidelines and statements circulation cme information for. Potassium disorders can cause major complications and must be avoided in critically ill patients. Pedsap 2018 book 2 fluids, electrolytes, and nutrition. We aim to combine the potassium and the glucose algorithm in the future. If creatinine greater than 2 mgdl andor documentation of renal failure or dialysis, contact physician for specific replacement orders. Exchange resins eg kayexalate po dose takes effect in 1.
If serum magnesium johns hopkins hospital, johns hopkins bayview medical center or johns hopkins community physicians. Permanent patient record patient identificaltion critical care protocol electrolyte replacement date time potassium replacement 1. 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. Beta2agonists shifts k into cells, duration 2 hours e. Significant electrolyte depletion can result in serious complications for patients.
The primary objective was to evaluate the efficacy of the electrolyte repletion protocol by. Electrolytes replacement protocol answers on healthtap. Electrolyte replacement practice management guidelines. Fluid and electrolyte management billie bartel and elizabeth gau le a r n i n g objectives 1. University of michigan healthsystem adult intensive care.
Potassium replacement protocol intravenous recommended rate of infusion is 10 meqh. Measurement of electrolytes is a commonly performed diagnostic procedure. The electrolyte replacement protocols, calcium chloride level i areas only or calcium gluconate all levels of care, magnesium sulfate. Nutrition journal of parenteral and enteral american society for. Intravenous electrolyte replacement can produce lifethreatening complications, serious arrhythmias and phlebitis. When indicated, the maximum amount of iv potassium replacement. The use of a potassium replacement protocol can improve potassium regulation. Lifethreatening electrolyte abnormalities circulation. Standard potassium and magnesium replacement protocol. Sodium bicarbonate shifts k into cells, duration 2 hours, less efficacious than insulinalbuterol c.
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