Protocol Requirements
1
Patient Criteria
ICU level of care, on cardiac monitor, serum creatinine < 2 mg/dL, urinary output > or = to 0.5 mL/kg/hour for the last 8 hours
2
Laboratory Tests
Daily labs include BMP, Magnesium, Ionized Calcium
3
Replacement Guidelines
Protocol includes replacement guidance for Potassium, Magnesium and Ionized Calcium. Replace electrolytes based on the frequency of labs.
4
Important Notes
If patient has labs ordered more frequently than once daily, second set of labs should not be drawn until the replacement has been completed.
Note: Contact the physician and do not initiate the protocol if requirements are not met.
Potassium Repletion
IV Administration Orders
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PO Administration Orders
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Magnesium Repletion
- Note: Magnesium repletion by IV only
IV Administration Orders
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Calcium Repletion
IV replacement only
No renal dosing for calcium gluconate
IV Administration Orders
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Calcium Replacement Guidelines
1
Use Corrected Ionized Calcium
Use the Ionized Calcium (Corrected) to determine replacement
2
Albumin Consideration
Corrected Ionized Calcium levels take into consideration the albumin level of the patient
3
Accurate Calculation
This method most accurately calculates calcium levels in the blood