Electrolyte Repletion
Potassium: 
 • Goal: CAD/arrhythmia: ...
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Description

Electrolyte Repletion

Potassium: 

 • Goal: CAD/arrhythmia: ≥4, Everyone else: ≥3.5, Do not replete if on HD unless <3.0

 • PO Repletion: KCl IR (packets): q4-6 hr, KCl ER (pills): giant pills, If K <3.5, ≥20 mEq KCl IR

 • IV Repletion: Peripheral IV: 10 mEq/hr, Central line: 20 mEq/hr w/ telemetry monitoring

 • 10 mEq K ↑ serum K by 0.1, Max 80 mEq → re-check K, Correct hypoMg

Magnesium: 

 • Goal: CAD/arrhythmia: ≥2, Everyone else ≥1.7

 • PO Repletion: Mg oxide 400mg (240 mg elemental Mg) TID x1 day

 • IV Repletion: Mg sulfate 2g IV

 • 2g will ↑ serum Mg by 0.5, ↓Mg can cause ↓K and ↓Ca

Phosphorus: 

 • Goal: Replete if sx or phos <1, At risk for refeeding syndrome: >2

 • PO Repletion: K-Phos: 1 packet QID, Neutra-Phos: 1 packet QID

 • IV Repletion: Give 15-45 mmol phos at a time, K-Phos (1.5 mEq K/mmol phos), Na-Phos (1.3 mEq Na/mmol phos)

 • IV Phosphate can precipitate Ca → causing hypocalcemia

Calcium:

 • Goal: Replete if sx, long QTc, Ca <7.5

 • PO Repletion: Ca carbonate 1250 mg PO BID

 • IV Repletion: Ca gluconate 1-2 gm IV

 • Correct for low Alb and hyperphos first, 1g Ca gluconate ↑ serum Ca by 0.5



#Electrolyte #Repletion #Potassium #Magnesium #Calcium #Phosphorus #Management
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