Too much sodium; give fluids. Too little sodium; limit fluid intake. You don’t want to correct too fast in either directions. Risk of cerebral edema if it falls too quickly, and a risk of osmotic demyelination if it rises too quickly.
Important pottasium points: it’s a vesicant if hypokalemia is severe give it fast centeral line, if it’s moderate and they’re asymptomatic peripheral line slow choose a big vein it burns!, if they’re symptomatic arrhythmia tachycardia centeral line, if it’s low or mild prob give oral now if they’re having metabolic acidosis on top of low pottasium give them oral pottasium bicarbonate… also key point don’t push or bolus pottasium ever this isn’t a prison. watch out for patients who have oliguria, they will accumulate pottaisum in the body and youlle give them a deadly arrhythmia! Don’t give pottaisum to a hypokalemic who has olguria!
I've been a nurse 30 years and I listen to your lessons every day. I learn something beneficial every day and helps me give the best care I can. Thank you for sharing your knowledge! 8/28/23 11:30 a.m.
This is awesome. One of the reasons I love doing these videos so much is that they 1) help refresh things and 2) Im always learning something new along the way.
If you give a patient 40 mEqs of Kcl + 30ml of saline (50ml total) at a velocity of about 20ml/hour through syringe pump, how does this translate to actual serum Kcl increases? I read a study that said that increases are actually "low", we talk about 0.3 to 0.6 mEq serum increase with 40meq
I had 3 weeks of diarhea from a supplement that was causing it. I was hit with a headache and stopped urinating for 8 hours. Now I suffer chronic electrolyte imbalance symptoms that I cannot fix. The doctor told me I'm crazy and it should have corrected with water consumption. I feel worse than trash.
What about Natrium? It would have been usefull if you would have mentioned the formulas used for the correction of Potassium and Natrium in hyponatremia and hypokalemia. Great videos!
As a paramedic I administer Ca Chloride via IV for hyperkalemia (w/ bicarb), acidosis, Calcium channel blocker overdoses, etc. So my question is why is a central line preferred for replacement therapy?
CaCl2 can be a vessicant. If calcium must be given via peripheral IV, calcium gluconate can be used, if only chloride is available, dilute it with saline. And always make sure to flush well or use a separate line for your bicarb
Thank you for the amazing video, one question, when replacing potassium do you have to add the daily requirements of potassium to the amount of potassium that you're giving for the deficit?
Thanks for the video. Can you elaborate more on "IV Replacement can lead to complications & life threatening situations?" Did you just mean that replacing too quickly can lead to arrhythmias, supratherapeutic adverse effects, pain in IV sites, etc?
regarding the protocols you have showed us? you said it depends on the hospital where you are working. from where you are working? what book you might recommend as reference for the protocols? thank you.
You should write everything important that you are saying, For ex at 2:28 you said "the lower the pH the higher the potassium" but you didn't write it down. 11:58 "If patient didn't respond to the replacement, check magnesium level" but you only write "check mg?" Consider it like a slide presentation, all info should be contained in the slide whenever possible.
Also remember to never crush PO replacements of potassium. Splitting the pill in half is okay but never crush potassium as it will release the entire drug at once thus increasing S/E.
disagree Giving potassium too fast is dangerous only when it is given via IV route. Enteral absorption of potassium is slow enough. So you are safe even if you eat a lot of powdered potassium at once. Powdered potassium tastes terribe, and this is the reason why potassium shouldn't be crushed.
These videos are awesome. Thank you! New graduate that is out of orientation. Great just to listen to as a refresher or explains stuff that my preceptors didn't really have an answer to.
Awesome, glad you liked it man! I try to make these videos as resources for people because theres always so much to learn, and certainly things that often do get missed in orientation and schooling.
Feel so blessed finding your channel, thank you for the great content. My question is do you have a location where I could get this testing and protocol?
Yes sorry! I am in the midst of preparing for a cross country move next month. I needed to slow down for a little bit but once I get settled in, I plan to get back to the 2 videos a week schedule!
