0 of 4 selectedpotassium chloride repletion sliding scale for ICU
ICU electrolyte sliding scale protocol
potassium chloride CR tablet
20-40 mEq, Oral, Every 2 hour PRN, per ICU electrolyte sliding scale, For ICU use only. For serum potassium < 3 mEq/L, check electrolytes in 8-12 hour per protocol. Hold if SCr >= 2 mg/dL and call MD. If serum potassium < 3 mEq/L, give 40 mEq q2h x 2 doses for total of 80 mEq and call MD. If serum potassium = 3-3.4 mEq/L, give 40 mEq x1, wait 2 hours, and then give 20 mEq x1 for total of 60 mEq. If serum potassium = 3.5-3.9 mEq/L, give 40 mEq x1.
potassium chloride solution
20-40 mEq, Oral, Every 1 hour prn, per ICU electrolyte sliding scale, For ICU use only. For serum potassium < 3 mEq/L, check electrolytes in 8-12 hour per protocol. Hold if SCr >= 2 mg/dL and call MD. If serum potassium < 3 mEq/L, give 40 mEq q1h x 2 doses for total of 80 mEq and call MD. If serum potassium = 3-3.4 mEq/L, give 40 mEq x1, wait 1 hour, and then give 20 mEq x1 for total of 60 mEq. If serum potassium = 3.5-3.9 mEq/L, give 40 mEq x1.
potassium chloride IV *peripheral line*
10 mEq, Intravenous, for 60 Minutes, Every 1 hour prn, per ICU electrolyte sliding scale, For ICU use only. For serum potassium < 3 mEq/L, check electrolytes in 8-12 hour per protocol. Hold if SCr >= 2 mg/dL and call MD. If serum potassium < 3 mEq/L, give 10 mEq IV q1h x 4 doses for total of 40 mEq and call MD. If serum potassium = 3-3.4 mEq/L, give 10 mEq IV q1h x 4 doses for total of 40 mEq. If serum potassium = 3.5-3.9 mEq/L, give 10 mEq q1h x 2 doses for total of 20 mEq.
potassium chloride IV *central line only*
20 mEq, Intravenous, Every 1 hour prn, per ICU electrolyte sliding scale, For ICU use only. For serum potassium < 3 mEq/L , check electrolytes in 8-12 hour per protocol. Hold if SCr >= 2 mg/dL and call MD. If serum potassium < 3 mEq/L, give 20 mEq IV q1h x 3 doses for total of 60 mEq and call MD. If serum potassium = 3-3.4 mEq/L, give 20 mEq IV q1h x 2 doses for total of 40 mEq. If serum potassium = 3.5-3.9 mEq/L, give 20 mEq x1.
0 of 2 selectedmagnesium sulfate repletion sliding scale for ICU
ICU electrolyte sliding scale protocol
magnesium oxide tablet
800 mg, Oral, Every 8 hours PRN, per ICU electrolyte sliding scale, For ICU use only. For serum magnesium < 1.3 mg/dL, check electrolytes in 8-12 hour per protocol. Hold if SCr >= 2 mg/dL and call MD. If serum magnesium < 1.3 mg/dL, give 800 mg q8h x 3 doses and call MD. If serum magnesium = 1.3-1.5 mg/dL, give 800 mg q8h x 2 doses. If serum magnesium = 1.6-1.9 mg/dL, give 800 mg q8h x 1 dose.
magnesium sulfate IV
1 g, Intravenous, Every 1 hour prn, per ICU electrolyte sliding scale, For ICU use only. For serum magnesium < 1.3 mg/dL, check electrolytes in 8-12 hour per protocol. Hold if SCr >= 2 mg/dL and call MD. If serum magnesium < 1.3 mg/dL, give 1g IV q1h x 4 doses for total of 4g and call MD. If serum magnesium = 1.3 -1.5 mg/dL, give 1g IV q1h x 3 doses for total of 3g. If serum magnesium = 1.6 -1.9 mg/dL, give 1g IV q1h x 2 doses for total of 2g. Infusion rates exceeding 1g/hour may be less effective due to enhanced renal elimination with rapid infusions. For asymptomatic patients, infusion rates should not exceed 1g/hour. In symptomatic patients, infusion rates should not exceed 2g/hour.
0 of 3 selectedphosphorous repletion sliding scale for ICU
ICU electrolyte sliding scale protocol
potassium & sodium phosphates tablet
1 tablet, Oral, Every 6 hours PRN, per ICU electrolyte sliding scale, for 7 days, For ICU use only. For serum phosphorous < 1.3 mg/dL, check electrolytes in 8-12h per protocol. Hold if SCr >= 2 mg/dL and call MD. If serum phosphorous < 1.3 mg/dL, give 1 tablet PO q6h x 4 doses and call MD. If serum phosphorous = 1.3-1.9 mg/dL, give 1 tablet PO q6h x 3 doses. If serum phosphorous = 2-2.7 mg/dL, give 1 tablet PO q6h x 2 doses.
potassium phosphate 15 mmol in sodium chloride 0.9 % 250 mL infusion
15 mmol, Intravenous, Every 2 hour PRN, per ICU electrolyte sliding scale, For ICU use only. For serum phosphorous < 1.3 mg/dL, check electrolytes in 8-12h per protocol. Hold if SCr >= 2 mg/dL and call MD. If serum phosphorous < 1.3 mg/dL, give 15 mmol IV q2h x 2 doses and call MD. If serum phosphorous = 1.3-1.9 mg/dL, give 15 mmol IV once. If serum phosphorous = 2-2.7 mg/dL, IV repletion is not indicated.
sodium phosphate 15 mmol in dextrose 5 % 250 mL IV
15 mmol, Intravenous, Every 2 hour PRN, per ICU electrolyte sliding scale, For ICU use only. For serum phosphorous < 1.3 mg/dL, check electrolytes in 8-12h per protocol. Hold if SCr >= 2 mg/dL and call MD. If serum phosphorous < 1.3 mg/dL, give 15 mmol IV q2h x 2 doses and call MD. If serum phosphorous = 1.3-1.9 mg/dL, give 15 mmol IV once. If serum phosphorous = 2-2.7 mg/dL, IV repletion is not indicated.
- IV or Oral KCl
-
- 3.7-3.9 = 20 mEq KCl
- 3.5-3.6 = 40 mEq KCl
- 3.3-3.4 = 60 mEq KCl
- 3.1-3.2 = 80 mEq KCl
- <3.0 = 100 mEq KCl (give IV)
Hypomagnesia
- IV form = MgSO4, write out “magnesium sulfate” at SFGH, rate 1g/hour.
-
- 1.8-1.9 = 1 g
- 1.6-1.7 = 2 g
- 1.4-1.5 = 3 g
- 1.2-1.3 = 4 g
- <1.2 g = 5 g
Oral form: 400 mg Mg oxide = 1 g MgSO4 IV
Hypophosphatemia: Oral form (preferred) PhosNaK (250 mg tablets) = 8 mmol. IV form sodium phosphate (if K>3.5) or K phosphate (if K<3.5). NaPhos is safe bet since can correct K w KCl if needed.
- 1.6-2.1 = 10 mmol IV NaPhos or KPhos (wt based dosing @ 0.15 mmol/kg so 10 mmol is based on 70 kg person)
- 1.2-1.5 = 15 mmol IV NaPhos or KPhos
- 0.8-1.1 = 20 mmol IV NaPhos or KPhos
- <0.8 = 30-40 mmol IV NaPhos or KPhos
Hypocalcemia: (use corrected calcium based on serum albumin, or ionized calcium)
Corrected Ca = ((4- serum albumin) x 0.8) + measured Ca++
- Goal Ca >9
- PO: CaCO3 500-1000 mg PO TID between meals
- IV: 1 g Ca gluconate IV (if iCa <1, then give 2 g)