PLACE LABEL HERE
ELECTROLYTE REPLACEMENT
CARDIOVASCULAR SURGERY
PROTOCOL
1.
2.
3.
4.
The following orders will be implemented
per physician order of this protocol.
This order is for use in Cardiovascular Care Unit (CVC). Discontinue when transferred out of CVC.
Notify physician prior to use if GFR or CrCl < 30 ml/min, creatinine is > 2, or urine output < 30 ml/hr.
D/C magnesium replacement in patients with acute exacerbation of Myasthenia Gravis
MEDICATIONS:
Potassium Replacement:
Replacement as Potassium Chloride (KCL)
Serum Potassium
(mmol/L)
(oral route preferred)
3.8 - 3.9
KCl 20 mEq po or IVPB x 1 dose
KCL 20 mEq po q 2 hrs x 2 doses
or
3.5 - 3.7
40 mEq IVPB over 2 hrs x 1 dose
KCl 40 mEq po, wait 2 hrs then give 20 mEq po for a
total of 60 mEq
or
3 - 3.4
KCl 40 mEq IVPB over 2 hrs, then give 20 mEq IVPB
over 1 hr for a total of 60 mEq
KCl 40 mEq IVPB over 2 hrs, then give 20 mEq IVPB
<3
over 1 hr for a total of 60 mEq and call physician
Laboratory
Repeat serum
potassium
2 hrs after dose
completed
Magnesium Replacement: D/C magnesium replacement in patients with acute exacerbation of Myasthenia Gravis
Serum Magnesium
(mg/dL)
Replacement as Magnesium Sulfate
1.7 - 2
2 gms IVPB over 1 hr x 1 dose
1.2 - 1.6
3 gms IVPB over 2 hrs x 1 dose
< 1.2
4 gms IVPB over 2 hrs and call physician
Laboratory
Repeat serum
magnesium
2 hrs after infusion
completed
Phosphate Replacement:
Serum Phosphate
(mg/dL)
Replacement as
potassium & sodium phosphate oral
2 - 2.4
Neutra-Phos (potassium phosphate, sodium phosphate)
1 packet po q 6 hrs x 48 hrs
1.5 - 1.9
Neutra-Phos (potassium phosphate, sodium phosphate)
2 packet po q 6 hrs x 48 hrs
< 1.5
______________
Date
Laboratory
Repeat serum
phosphate
level in AM
Call physician for phosphate replacement.
_____________
Time
_________________________________
Physician Signature
___________
PID Number
Copy to pharmacy
*1-40046*
FORM 1-40046 REV. 06/2015
Page 1 of 1
ELECTROLYTE REPLACEMENT
CARDIOVASCULAR SURGERY
PROTOCOL
Reference Page
(For use with form 40046)
PLACE THIS COPY IN MAR SECTION OF CHART FOR DURATION OF CARE.
Potassium Replacement:
Serum Potassium
(mmol/L)
3.8 - 3.9
3.5 - 3.7
3 - 3.4
<3
Replacement as Potassium Chloride (KCL)
(oral route preferred)
KCl 20 mEq po or IVPB x 1 dose
KCL 20 mEq po q 2 hrs x 2 doses
or
40 mEq IVPB over 2 hrs x 1 dose
KCl 40 mEq po, wait 2 hrs then give 20 mEq po for a
total of 60 mEq
or
KCl 40 mEq IVPB over 2 hrs, then give 20 mEq IVPB
over 1 hr for a total of 60 mEq
KCl 40 mEq IVPB over 2 hrs, then give 20 mEq IVPB
over 1 hr for a total of 60 mEq and call physician
Laboratory
Repeat serum
potassium
2 hrs after dose
completed
Magnesium Replacement: D/C magnesium replacement in patients with acute exacerbation of Myasthenia Gravis
Serum Magnesium
(mg/dL)
1.7 - 2
2 gms IVPB over 1 hr x 1 dose
1.2 - 1.6
3 gms IVPB over 2 hrs x 1 dose
< 1.2
Replacement as Magnesium Sulfate
4 gms IVPB over 2 hrs and call physician
Laboratory
Repeat serum
magnesium
2 hrs after infusion
completed
Phosphate Replacement:
Serum Phosphate
(mg/dL)
Replacement as
potassium & sodium phosphate oral
2 - 2.4
Neutra-Phos (potassium phosphate, sodium phosphate)
1 packet po q 6 hrs x 48 hrs
1.5 - 1.9
Neutra-Phos (potassium phosphate, sodium phosphate)
2 packet po q 6 hrs x 48 hrs
< 1.5
Laboratory
Repeat serum
phosphate
level in AM
Call physician for phosphate replacement.
Nurse: Write a new order for each needed dose and lab, sign “per Dr. XX’s order / Your Name, RN”
Reference Use Only. Not Part of Medical Record.
(For use with form 40046)