What measures do you anticipate to correct in each of the imbalances described in

Question

Question 16?

What will be an ideal response?

Answer 1

• KCl will be diluted and given intravenously as a separate infusion similar to a piggyback. The
physician will order 40 mEq IVPB and check a basic metabolic panel (BMP) because an elevated
creatinine slows potassium excretion even though A.G. has an NGT.
• Because the rate must be carefully controlled, these doses are always infused by IV pumps. The
actual rate depends on the patient care setting and patient condition. Without telemetry, the rate
of KCl infusion must not be greater than 10 mEq/hr.
• An albumin level of 2.1 g/dL is not dangerously low. If the albumin were 1.5 g/dL, the physician
might order 25 g of normal serum albumin, which provides the same osmolality as 2 units of fresh
frozen plasma. Albumin expands plasma volume, maintains cardiac output (CO), and mobilizes
fluids from the interstitial space to the intravascular space.
• Na and Cl could be increased by changing the concentration of the maintenance IV as tolerated by
the patient (e.g., D5NS).
• Total parenteral nutrition (TPN) can be given via a peripherally inserted central catheter (PICC).
A.G. needs a nutrition consultation to start oral nutrition within 72 hours to prevent muscle
catabolism and bowel sloughing.
• All of the abnormalities could be regulated by giving TPN or nutritional supplements.