... when administering potassium chloride IV and the client complains of severe burning pain in the extremity in which it is infusing?
Potassium Chloride/Sodium Chloride - What actions does the manufacturer recommend the nurse take?
Question posted by bbeyer on 24 Jan 2012
Last updated on 12 March 2017
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5 Answers
IV potassium should be given using an IV piggy back with fluid bolos. Anyone infusing straight potassium alone through an IV without dilution should be shot! This is torture for the patient... The pain is unbearable even at the slowest rate. There is also a high probability of vein thrombosis especially in smaller veins such as the hand or wrist.
Hi Mary,
Potassium Chloride (KCL) is known to burn quite badly when infused into a vein.
I am not sure how much your brother is on--- 20mEq or 40mEq?? The higher the milliequivalent the more it will burn. The only way to help with the burning is to slow the infusion down it or infuse it into a larger vein. I am sure they r running it by a pump due to the need to control the speed of which it is infused. If KCl is given rapidly it can cause cardiac arrest.
IVs that are in the hand burn more than those put in the area around the bend of the arm. You can usually get a larger
Bore IV in that spot. Unfortunately potassium will always burn when given IV. If a cental line is in... the IVs that are located around the neck or clavicle area the pain will not be present.
Is your brother not able to take potassium by mouth???
Anyway... so sorry he going thru this. I hope he gets better soon. Love pup
They are now giving it by mouth. thanks pup. Mary
So sorry B... I thought Mary asked this question. Hi Mary... glad your brother is getting potassium by mouth. It is very caustic to the veins.
Stay well... pup
They still haven't figured out what is causing the allergic reaction if that is what it is that has him red & swollen all up all over. Tis perplexing for sure. Thanks, Pup... Mary
IV potassium (K+) is VERY painful especially in smaller veins. You have a few options, one is to run it slow (you might need to run this past the ordering doc if fluids are running different than TKO/KVO) the other is to change the IV site and pick the largest vein you can access. It seems to hurt a little less if the vein is larger. The ones in the hand are too small and cause more burning-try to access something further up on the arm from where the access is right now. Sometimes it helps to put a heat pack or ice pack over the site just dont let the patient burn their skin with either one. Keep a close eye on the tissues so the pack doesnt cause a burn which can be even worse than the IV K+. Be sure you agitate the IV bag before hanging, too, to be sure the K+ isnt sitting in a bolus in the IV. Agitate it a bit to be sure the K+ is dispersed throughout the bag.
Hi bbeyer,
This patient should be given pain medication!! Having an iv of potassium is supposedly incredibly painful! Is this happening to one of your loved ones? If so, plead for pain medication for the patient.
Best wishes
Good morning Sis, we must have been typing at the same time!. How are you today? Love, Mary
Hi Mary, still in fibro flare, and it HURTS big time. How are you my friend?
Everything OK with bro, and YOU??
xoxo
of course not! Still the same. Am getting ready to dress & run over to docs office for labs right now. TTYL. Love, Mar
Hey Sweets - sorry to hear about the fibro flare! Dang! I woke up Sat morning to my worst arthritis flare ever - just incredible the pain/swelling. Pain specialist is sending me to a rheumy but one in 2008 said they couldn't help since it was osteo. Amazing at how our bodies can turn on us! Hope you get feeling better Sweets! (my apologies for hijacking this thread. I'm sorry - I don't have any suggestions for you. I hope you can find an answer). - ElizaJane
Thanks EJ, and right back at you my friend! Good luck at the rheumy, let us know what happens?
Lara
xx
Are you on other drugs such as furosimide. My brother is in the hospital at this moment having a severe reacion to having potassium added to his IV while on furosimide, & is having a horrible reaction to it. Please read the link I will try to provide try to read it all, & at the bottom of the page is another section that gives you more options. Please go to Furosiemide Side Effects (in more detail), read that also, the hit you back arrow, & it will take you right back to the to the previous page where you chose side effects, now go further down this page, to the last in blue "Med facts (in blue) Med Facts Furosimide comsumer leaflet. I hope I have explanied this well enough for you to understand. If not, please feel free to ask me again...
https://www.drugs.com/furosemide.html
Mary, what kind of reaction is your brother having to the potassium? because they ALWAYS give potassium with furosemide. Furosemide depletes potassium which causes hypokalemia and can effect the heart so you always see furosemide and potassium together.
Dzoo, I was wrong about furisomide, it was lisinoril with Ivp solution with potassium. they are giving him. He is also on furisomide , metolazone,terazosin, metolazone,levothyroxine, & metopopral(sp) . The drug intereactor gave a major reaction for ivp potassium with lisinopril. My mistake. Sorry. He's not getting any better either.Oh he's also on coumadin, & simvastin & oxycodone.
You can ask the Doctor to add lidocaine (if no allergy)!to the IV potassium bag or check with the pharmacy but still run slowly through a larger view or central line if possible..central line shoudnt need lidocaine... potassium absorbs better by mouth vs IV bringing levels up faster and is prefered also comes in liquid form if pills are to big or don't disolve but must dilute with water or juice... I believe PO 40meq every 4 hours is max... don't take whole handful of pills. ..if giving IV is 10meq hour or 20meq if on heart monitor. ... I have given IV along with PO if levels really low and it works great ... hope this helps :)
Related topics
hypokalemia, pain, potassium chloride, burning
Further information
- Potassium Chloride uses and safety info
- Potassium Chloride prescribing info & package insert (for Health Professionals)
- Side effects of Potassium Chloride (detailed)
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