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Potassium Chloride Drug name ( Generic and Trade)

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Cena-K, Gen-K, K+Care, K+10, Kaochlor, Koachlor S-F, Kaon-Cl, Kay Ciel, KCl, K-Dur, K-Lease, K-Lor, Klor-Con, Klorvess Liquid, Klotrix, K-Lyte/Cl Powder, K-Med, K-Norm, K-Sol, K-Tab, Micro-K, Micro-K ExtenCaps, Micro-LS, Potasalan, Roychlor, Rum-K, Slow-K, Ten-K

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Potassium Chloride Classification and sub classification

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Therapeutic- mineral and electrolyte replacements/supplements

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Potassium Chloride Therapeutic Action

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Replacement. Prevention of deficiency

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Potassium Chloride Side effects

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CNS- confusion, restlessness, weakness CV-Arrhithmias, ECG changes GI- abdominal pain, diarrhea, flatulence, nausea, vomiting Tablets & capsules only- GI ulceration, stenotic lesions Local- irritation at IV site Neuro- paralysis, paresthesia

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Potassium Chloride Nursing implications Assessment

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Assess for s/s of hypokalemia and hyperkalemia.

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Potassium Chloride Nursing implications Assessment

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Monitor pulse, BP, and ECG periodically during IV therapy

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Potassium Chloride Nursing implications Assessment

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Monitor serum K before and periodically during therapy. Monitor renal function, serum bicarbonate, and pH. Determine serum Mg levels if patient had refractory hypokalemia; hypomagnesemia should be corrected to facilitate effectiveness of K replacement. Monitor serum Cl because hypochlyorimia may occur if replacing K without concurrent Cl.

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Potassium Chloride Nursing implications Assessment Toxicity and OD

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Symptoms of toxicity are those of hyperkalemia. Treatment includes discontinuation of K, administration of Na bicarbonate to correct acidosis, dextrose and insulin to facilitate passage of K into cells, calcium salts to reverse ECG effects (In pt who are not receiving digoxin), sodium polystyrene used as an exchange resin, and/or dialysis for pt with impaired renal function

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Potassium Chloride Nursing implications Potential Nursing Diagnosis

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Imbalanced nutrition; less than body requirements

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Potassium Chloride Nursing implications Implementation High Alert

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Med errors involving too rapid infusion or bolus IV administration of KCl have resulted in fatalities.

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Potassium Chloride Nursing implications Implementation

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Do not confuse K-Dur with Imdur. Do not confuse Micro-K with micronase.

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Potassium Chloride Nursing implications Implementation

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For most purposes, KCl should be used, except for renal tubular acidosis (hyperchloremic acidosis), in which other salts are more appropriate (K bicarbonate, K citrate, or K gluconate)

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Potassium Chloride Nursing implications Implementation

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If hypokalemia is secondary to diuretic therapy, consideration should be given to decreasing the dose of the diuretic, unless there is a history of significant arrhythmias or concurrent digitalis glycoside therapy.

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Potassium Chloride Nursing implications Implementation

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Administer with or after meals to decrease GI irritation

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Potassium Chloride Nursing implications Implementation

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Use of tablets and capsules should be reserved for patients who cannot tolerate liquid preparations

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Potassium Chloride Nursing implications Implementation

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Dissolve effervescent tablets in 3-8 oz of cold water. Ensure that effervescent tablet is fully dissolved. Powders and solutions should be diluted in 3-8 oz of cold water of juice. Instruct pt to drink slowly over 5-10 mins

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Potassium Chloride Nursing implications Implementation

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Tablets and capsules should be taken with a meal and full glass of water. DO NOT chew or crush enteric-coated or extended-release tablets or capsules. Micro-K ExtenCaps capsules can be opened and sprinkled on soft food and swallowed immediately with a glass of water or juice.

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Potassium Chloride Nursing implications Implementation

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Assess for extravasation; severe pain and tissue necrosis may occur.

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Potassium Chloride Nursing implications Implementation High Alert

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Never administer K IV push or bolus

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Potassium Chloride Nursing implications Implementation Continuous Infusion High Alert

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Do not administer concentrations of more than 1.5mEq/ml undiluted; fatalities have occurred. Concentrated products have black caps on vials or black stripes above constriction on ampules and are labeled with a warning about dilution requirement. Each single dose must be diluted and throughly mixed in 100-1000 ml of IV solution. Usually limited to 80 mEq/L via peripheral line (200 mEq/L via central line)

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Potassium Chloride Nursing implications Implementation

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Concentrations of 0.1 or 0.4 mEq/ml are intended for administration via calibrated infusion device and do not required dilution

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Potassium Chloride Nursing implications Implementation High Alert

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Infuse slowly, at a rate up to 10mEq/kg/hr in children in general care areas. Check hospital policy for maximum infusion rates. Use an infusion pump

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Potassium Chloride Nursing implications Pt/family teaching

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Explain to pt purpose of the med and the need to take as directed, especially when concurrent digoxin or diuretics are taken. A missed dose should be taken as soon as remembered within 2 hr; if not, return to regular dose schedule. Do not double dose.

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Potassium Chloride Nursing implications Pt/family teaching

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Emphasize correct method of administration. GI irritation or ulceration may result from chewing enteric-coated tablets or insufficient dilution of liquid or powder forms.

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Potassium Chloride Nursing implications Pt/family teaching

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Some extended release tablets are contained in a wax matrix that may be expelled in the stool. This occurrence is not significant

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Potassium Chloride Nursing implications Pt/family teaching

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Instruct pt to avoid salt substitutes or low-salt milk or food unless approved by HCP. Pt should be advised to read all labels to prevent excess K intake

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Potassium Chloride Nursing implications Pt/family teaching

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Advise pt regarding sources of dietary K. Encourage compliance with recommended diet.

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Potassium Chloride Nursing implications Pt/family teaching

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Instruct pt to report dark, tarry, or bloody stools; weakness; unusual fatigue; or tingling of extremities. Notify HCP if nausea, vomiting, diarrhea, or stomach discomfort persists. Dosage may require adjustment.

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Potassium Chloride Nursing implications Pt/family teaching

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Emphasize the importance of regular follow up exams to monitor serum levels and progress

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