Tonicity decides where infused water goes, potassium is never pushed and always pumped, and delegating a task never delegates the accountability. Pick the fluid for six patients, then build a potassium order and let the bench check it against the absolute rules, then hand out a shift’s work across RN, LPN and UAP.
Mr. Whitfield, 62. Serum potassium 2.9 mEq/L after four days of furosemide and vomiting. He has a 20-gauge peripheral IV in the right forearm. Urine output has been 45 mL/hr, creatinine 0.9 mg/dL. He is not on a cardiac monitor and he is on a regular medical-surgical floor. The provider has ordered potassium chloride replacement. Build the order.
Route and delivery
Concentration of the bag
Vascular access
Infusion rate
Before you hang it
You have an RN (yourself), an LPN and a UAP. These nine items are on your fluid-balance plan of care for the shift. Assign each one, then check. Remember: the UAP may not assess, interpret, teach or evaluate, and the RN keeps every intravenous push, every high-alert infusion and every unstable patient.