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Guidelines for Electrolyte Replacement EXCLUSIONS: Patients with the following: hemodialysis/peritoneal dialysis, acute kidney injury (AKI), creatinine clearance <30mL/min, chronic adrenal insufficiency, electrical burns, rhabdomyolysis, DKA, crush injury, hypothermia, or have active transfer orders out of the ICU/Step Down Unit
The primary outcome of the meeting was the development of guidelines for potassium replacement therapy. These guidelines represent a consensus of the Council members and are intended to provide a general approach to the prevention and treatment of hypokalemia.
Potassium replacement is primarily indicated when hypokalemia is due to potassium loss, and there is a significant deficit in body potassium. It is also warranted for acute therapy in disorders such as hypokalemic or thyrotoxic periodic paralysis in which the hypokalemia is due to redistribution of potassium into the cells, often in association ...
Always look at potassium level to determine appropriate IV phosphorus product: use K Phos if K < 4.0 mEq/L and Na Phos if K 4.0 mEq/L. For IV replacement: Pharmacy will dilute in 250mL NS or D5W.
This guideline covers the treatment of acute hypokalaemia in adults on general medical and surgical wards. It does not cover the treatment of diabetic ketoacidosis (DKA) patients or patients whose hypokalaemia is being managed by additions to total parenteral nutrition (TPN).
Intravenous piggyback infusions of electrolytes must be administered with free-flow protected infusion devices (i.e. infusion pump). Patients must meet the following criteria prior to initiation of the Potassium, Magnesium, or Phosphorus protocols: SCr < 2 mg/dL. Weight > 40 kg.
Patients with potassium levels of 2.5–3.5 mEq/L (representing mild to moderate hypokalemia), may need only oral potassium replacement. If potassium levels are less than 2.5 mEq/L, intravenous (i.v.) potassium should be given, with close follow-up, continuous ECG monitoring, and serial potassium levels measurements.
Signs and Symptoms. Manifestations of hypokalaemia depend upon the severity of potassium depletion – see below: 3.0 – 3.4mmol/L – Usually asymptomatic, but symptoms may include arrhythmias*, weakness, constipation, nausea, muscle cramps and fatigue.
The World Health Organization recommends a potassium intake of at least 3,510 mg per day for optimal cardiovascular health. Hypokalemia is caused by decreased intake, renal losses,...
This study explores the relationship between potassium replacement in the emergency department (ED) and hospital mortality in patients with mild hypokalemia.