Electrolyte Replacement Protocol

Electrolyte Replacement Protocol
Policy CC.13.001.02.02
This protocol outlines the requirements and procedures for electrolyte replacement in an intensive care setting. It provides guidance for healthcare professionals to ensure proper management of potassium, magnesium, and calcium levels in patients meeting specific criteria.
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

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