10-24-2007, 05:10 AM
2nd post op day nurse informs you of EKG changes and K+ 6.8. how do we manage?
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CCs-2nd postop day - jahnavi34
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10-24-2007, 05:44 AM
stop any K containing fluids..ringers espcially..and drugs that worsen it..ACEI, K sparing diuretics etc.
give insulin + dextrose.. give IV Calcium give Sod. bicarb. very carefully monitor for arrythmias check renal function/monitor output find cause of hyper: hemolysis/rhabdomyolysis etc...blood transfusion occ cause it. u can give Kayexelate, but if patient is NPO..avoid it.. if no change....hemodialysis
10-24-2007, 06:13 AM
well i heard one of my friends got this case and the pt didnot improve... i mean K+ levels did not improve....
few more things 1)NaHCO3 carefully, we dont have to worry as nurese takes care of it rite?? what are the additional things we need to do. 2)What do we actually do to check renal func and monitor output.... is it just order bun/creatinine, dip stick for blood, u/a and maitian input/output chart or anythingelse.... 3) say if the blood transfusion has already been given and now bld is not given... what to do next...
10-24-2007, 06:19 AM
patient not improving...if that means he/she is not deteriorating..like no arrythmias..continue with insulin/glucose and check K every 4 hours..within 8 hours K will come down..if not u have to go for Hemodialysis...which is rarely needed with good renal function,'coz insulin is bound to drive K intracellularly...
dont give further blood transfusion with stored blood..give fresh blood if needed... Nahco3 is notorious for causing cellulitis....so if possible use if as a last resort.. ur right about renal function |
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