k supplements and intravenous solutions notes

8/2/2019 K Supplements and Intravenous Solutions Notes

1/4

Potassium (K) supplements (*Check pg. 516 for a complete drug profile)

-prevents/treats potassium depletion-oral administration available by the acetate, bicarbonate, chloride, citrate, and gluconate salts of K-intravenous administration available by the acetate, chloride, and phosphate salt forms of K-dosage usually expressed in mmol-K is contraindicated in patients with severe kidney disease, severe hemolytic (liver) disease, or Addisonsdisease and in those suffering from hyperkalemia, acute dehydration, or major tissue breakdown resulting frommultiple traumas

-K is available in many forms such as tablet, capsule, elixir, and injection

(Reference: pharmacology textbook)

Slow K (potassium chloride/K-Dur)

Slow-K, potassium chloride extended-release tablets USP, is a sugar-coated (not enteric-coated) tablet for oral

administration, containing 600 mg of potassium chloride (equivalent to 8 mEq) in a wax matrix. This formulation

is intended to provide an extended-release of potassium from the matrix to minimize the likelihood of producing

high, localized concentrations of potassium within the gastrointestinal tract.

Slow-K (potassium chloride) is an electrolyte replenisher. Its chemical name is potassium chloride, and its

structural formula is KCI. Potassium chloride USP is a white, granular powder or colorless crystals, odorless

and has a saline taste. Its solutions are neutral to litmus. It is freely soluble in water and insoluble in alcohol.

(Reference:http://www.rxlist.com/slow-k-drug.htm)

What is the most important information I should know about potassium chloride?

You should not use this medication if you have kidney failure, Addison's disease, severe burns or othertissue injury, if you are dehydrated, if you take certain diuretics (water pills), or if you have high levels ofpotassium in your blood (hyperkalemia).

Do not crush, chew, break, or suck on an extended-release tablet or capsule. Swallow the pill whole.Breaking or crushing the pill may cause too much of the drug to be released at one time.

Take this medication with food or just after a meal.

To be sure this medication is helping your condition, your blood may need to be tested often. Your heart ratemay also be checked using an electrocardiograph or ECG (sometimes called an EKG) to measure electricalactivity of the heart. This test will help your doctor determine how long to treat you with potassium.

Do not stop taking this medication without first talking to your doctor. If you stop taking potassium

suddenly, your condition may become worse.

What is potassium chloride?

Potassium is a mineral that is found in many foods and is needed for several functions of your body, especiallythe beating of your heart.

Potassium chloride is used to prevent or to treat low blood levels of potassium (hypokalemia). Potassium levelscan be low as a result of a disease or from taking certain medicines, or after a prolonged illness with diarrheaor vomiting.
http://www.rxlist.com/script/main/art.asp?articlekey=25976http://www.rxlist.com/script/main/art.asp?articlekey=39410http://www.rxlist.com/slow-k-drug.htmhttp://www.rxlist.com/slow-k-drug.htmhttp://www.rxlist.com/slow-k-drug.htmhttp://www.rxlist.com/slow-k-drug.htmhttp://www.rxlist.com/script/main/art.asp?articlekey=39410http://www.rxlist.com/script/main/art.asp?articlekey=25976


2/4

What should I discuss with my healthcare provider before taking potassium chloride?

You should not use this medication if you are allergic to it, or if you have certain conditions. Be sure yourdoctor knows if you have:

high levels of potassium in your blood (hyperkalemia); kidney failure; Addison's disease (an adrenal gland disorder); a large tissue injury such as a severe burn; if you are severely dehydrated; or if you are taking a "potassium-sparing" diuretic (water pill)

To make sure you can safely take potassium chloride, tell your doctor if you have any of these otherconditions:

kidney disease; heart disease or high blood pressure; a blockage in your stomach or intestines; or chronic diarrhea (such as ulcerative colitis, Crohn's disease).

FDA pregnancy category C. It is not known whether potassium chloride will harm an unborn baby. Tellyour doctor if you are pregnant or plan to become pregnant while using this medication.

How should I take potassium chloride?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer thanrecommended. Follow the directions on your prescription label.

Mix the powder, granule, or liquid form of this medicine with at least 4 ounces (one-half cup) of cold water orfruit juice before taking. Drink the mixture slowly, over 5 to 10 minutes in all. To make sure you get the entiredose, add a little more water to the same glass, swirl gently and drink right away.

Do not crush, chew, break, or suck on an extended-release tablet or capsule. Swallow the pill whole.Breaking or crushing the pill may cause too much of the drug to be released at one time. Sucking on apotassium tablet can irritate your mouth or throat.

Take this medication with food or just after a meal.

Your treatment may include a special diet. It is very important to follow the diet plan created for you byyour doctor or nutrition counselor. You should become very familiar with the list of foods you should eat oravoid to help control your condition.

Potassium-rich foods include: squash, baked potatoes (skin on), spinach, lentils, broccoli, brussels sprouts,zucchini, kidney or navy beans, raisins, watermelon, orange juice, bananas, cantaloupe, and low-fat milk oryogurt. Consume only the daily amounts recommended by your doctor or nutrition counselor.

To be sure this medication is helping your condition; your blood may need to be tested often. Your heart ratemay also be checked using an electrocardiograph or ECG (sometimes called an EKG) to measure electricalactivity of the heart. This test will help your doctor determine how long to treat you with potassium. Do not missany scheduled appointments.

Do not stop taking this medication without first talking to your doctor. If you stop taking potassiumsuddenly, your condition may become worse.


3/4

What should I avoid while taking potassium chloride?

Avoid taking potassium supplements or using other products that contain potassium without first askingyour doctor. Salt substitutes or low-salt dietary products often contain potassium. If you take certain productstogether you may accidentally get too much potassium. Read the label of any other medicine you are using tosee if it contains potassium.

What are the possible side effects of potassium chloride?

Get emergency medical help if you have any of these signs of an allergic reaction:hives; difficultybreathing; swelling of your face, lips, tongue, or throat.

Overdose symptoms may include heavy feeling in your arms or legs, confusion, weak or shallow breathing,slow or uneven heartbeat, seizure (convulsions), or feeling like you might pass out.

Stop using this medication and call your doctor at once if you have any of these serious side effects:

confusion, anxiety, feeling like you might pass out; uneven heartbeat; extreme thirst, increased urination; leg discomfort; muscle weakness or limp feeling; numbness or tingly feeling in your hands or feet, or around your mouth; severe stomach pain, ongoing diarrhea or vomiting; black, bloody, or tarry stools; or coughing up blood or vomit that looks like coffee grounds

Less serious side effects may include: mild nausea or upset stomach; mild or occasional diarrhea; slight tingling in your hands or feet; or appearance of a potassium chloride tablet in your stool

What other drugs will affect potassium chloride?

Tell your doctor about all other medicines you use, especially:-eplerenone (Inspra), digoxin, quinidine, a bronchodilator, an ACE inhibitor, or any type of diuretic (water pill)

Reference:https://online.epocrates.com/noFrame/showPage.do?method=drugs&MonographId=2038&ActiveSectionId=8

Intravenous Fluid and Electrolyte Replacement

-many clients need maintenance IV fluid therapy only while they cannot take oral fluids (e.g. before and aftersurgery), while others need replacement therapy for losses-amount and type of solution determined by the normal daily maintenance requirements and imbalances

identified by lab results-local complications may occur such as: phlebitis, ecchymosis, extravascular fluid infiltration, infection,thrombosis, and venous spasm-systemic complications include: bacteremia and sepsis, air embolism, and pulmonary edema

Reference: Medsurge textbook, pg. 388-389, (*Check Tab. 18-19 for full composition of various solutions)
https://online.epocrates.com/noFrame/showPage.do?method=drugs&MonographId=2038&ActiveSectionId=8https://online.epocrates.com/noFrame/showPage.do?method=drugs&MonographId=2038&ActiveSectionId=8https://online.epocrates.com/noFrame/showPage.do?method=drugs&MonographId=2038&ActiveSectionId=8


4/4

Intravenous Solutions

Hypotonic- provides more water than electrolytes, diluting the ECF. Osmosis then produces a movement ofwater from ECF to ICF osmotic equilibrium achieved ICF and ECF have same osmolality-potential for cellular swelling; clients should be monitored for cerebral edema-maintenance fluids are usually hypotonic solutions b/c normal daily losses are hypotonic

Isotonic- expands only the ECF; no net loss/gain from the ICF-ideal fluid replacement for a client with an ECF volume deficit

Hypertonic- initially raises osmolality of ECF and expands it; treats hypovolemia and hyponatremia-higher osmotic pressure draws water out of cells into ECF-monitor BP, lung sounds, and serum sodium levels and should be used with caution b/c of risk forintravascular fluid volume excess and intracellular dehydration

Intravenous addictives: KCl, CaCl, MgSO4, and HCO3- are commonly added to basic IV solutions

-recommendations for giving K vary, but in generally no more than 10-20 mEq/hr is considered safe for routineadmin. K can be safely diluted as 40 mEq/L of solution, with a max of 60 mEq/L.-never administer undiluted or by IV push b/c it can case fatal cardiac reactions

Plasma expanders- stay in vascular space & increase osmotic pressure include: colloids, dextran, & hetastarch

Colloids-are protein solutions such as plasma, albumin (5% or 25% solutions), and commercial plasmasDextran-a complex synthetic sugar; metabolizes slowly, but colloids are even slowerHetastarch- an esterified amylopectin-containing starch prescribed to treat hypovolemia in shock and is used inleukapheresis to help increase the yield of granulocytes.

5% dextrose in water (50 grams of glucose/L = 170 calories/L)-considered isotonic, but physiologically hypotonic b/c the dextrose is quickly metabolized-net result is admin of free water (hypotonic) with equal expansion of ECF and ICF-1L helps to prevent ketosis associated with starvation-pure water must not be administered intravenously b/c it would cause hemolysis of RBCsIndications:provides free water necessary for renal excretion of solutes, used to replace water losses and treathypernatremia, does not provide any electrolytes

Normal (0.9%) saline (154 mmol/L= [Na] = [Cl], 0 grams of glucose/L)Indications:-used to expand intravascular volume and replace extracellular fluid losses/sodium losses-only solution that may be administered with blood products-contains Na+ & Cl- in excess of plasma levels; thus, excessive admin can result in elevated Na & Cl levels-does not provide free water, calories, other electrolytes-may cause intravascular overload or hyperchloremic acidosis, considered isotonic

3 % saline (0 grams of glucose/L)Indications:-used to treat symptomatic hyponatremia, considered hypertonic

-must be administered slowly and with extreme caution b/c it may cause dangerous intravascular volumeoverload and pulmonary edema
http://2.bp.blogspot.com/_10M5kCPMTYM/S-1kTAlmmrI/AAAAAAAAABc/Duc-LSzYgyU/s1600/Bio+hypotonic,+Isotonic,+Hypertonic.gifhttp://2.bp.blogspot.com/_10M5kCPMTYM/S-1kTAlmmrI/AAAAAAAAABc/Duc-LSzYgyU/s1600/Bio+hypotonic,+Isotonic,+Hypertonic.gif

k supplements and intravenous solutions notes

Documents