Patient Care Skills Lab IV- Substance Abuse Background One of the most common types of substance abuse is alcohol use di

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Patient Care Skills Lab Iv Substance Abuse Background One Of The Most Common Types Of Substance Abuse Is Alcohol Use Di 1 (77.17 KiB) Viewed 18 times

Patient Care Skills Lab Iv Substance Abuse Background One Of The Most Common Types Of Substance Abuse Is Alcohol Use Di 2 (44.08 KiB) Viewed 18 times

Patient Care Skills Lab Iv Substance Abuse Background One Of The Most Common Types Of Substance Abuse Is Alcohol Use Di 3 (39.8 KiB) Viewed 18 times

Patient Care Skills Lab Iv Substance Abuse Background One Of The Most Common Types Of Substance Abuse Is Alcohol Use Di 4 (39.14 KiB) Viewed 18 times

Patient Care Skills Lab IV- Substance Abuse Background One of the most common types of substance abuse is alcohol use disorder. Alcohol use disorders such as alcohol intoxication and alcohol withdrawals are disruptive patterns of alcohol use. Alcohol withdrawal develops after a sudden cessation or reduction of alcohol use in patients with a history of heavy drinking. The onset and duration vary among different patients. Symptoms of alcohol withdrawal syndrome can range from minor symptoms such as insomnia, tremors, mild anxiety, palpitations and headache to severe symptoms such as seizures, hallucination and delirium. Part of the general care of treatment for alcohol withdrawal, especially when the patient is vomiting, is the replacement of electrolytes and nutrients such as potassium, magnesium, folic acid and thiamine. Potassium plays an important role in many metabolic functions including the maintenance of electrical action potential across the cell membrane, cellular metabolism and growth, protein and glycogen synthesis as well as normal blood pressure. Most of the body's potassium is intracellular and its gradient is maintained by the Na/K ATPase pump on the cell membrane. The body must maintain the potassium level in the blood within a narrow rage. A serum potassium level that is too high (hyperkalemia) or too low (hypokalemia) can have serious consequences, such as arrhythmia or even cardiac arrest. Hypokalemia is common in patients hospitalized for alcohol withdrawal. The cause of hypokalemia in alcoholism is usually multifactorial, which includes inadequate potassium intake and potassium loss secondary to vomiting. It is essential to correct potassium imbalances to prevent life-threatening consequences. Below are the different levels of potassium imbalances and some of the signs and symptoms: Hyperkalemia: O Mild: 5.5-6.0 mEq/L O Moderate: 6.1 -6.9 mEq/L O Severe: > 7 mEq/L o Signs and symptoms: muscle weakness or paralysis; abnormal cardiac conduction with peaked and narrowed T waves Hypokalemia: O Mild: 3.0-3.5 mEq/L 15875 O Moderate: 2.5-2.9 mEq/L o Severe: <2.5 mEq/L O Signs and symptoms: lower extremity muscle weakness that can progress to respiratory muscles (respiratory failure) and Gl muscles (paralytic ileus, N/V, constipation); EKG change with flattened T waves; cardiac arrhythmias including bradycardia, heart block and Vfib. ant
Patie Electrolyte Replacement: Potassium Pharmacokinetic Parameters Absorption Well absorbed from upper Gl tract Distribution (Vd): . Enters cell via active transport from extracellular fluid Metabolism Not known Excretion: . Primarily urine; skin and feces (small amounts); most intestinal potassium will be absorbed. Dosing Current Serum Potassium Level Central Line Peripheral Line Monitoring 3.6-3.9 mEq/L 20 mEq IV over 2 HR x 1 10 mEq IV over 1 HR x 2 No additional action) 3.4-3.5 mEq/L 20 mEq IV over 2 HR x 1 AND 10 mEq IV over 1 HR x 1 10 mEq IV over 1 HR x 3 No additional action 3.1-3.3 mEq/L 20 mEq IV over 2 HR x 2 10 mEq IV over 1 HR x 4 Recheck serum potassium level 2 hours after infusion complete 2.6-3.0 mEq/L 20 mEq IV over 2 HR x 2 10 mEq IV over 1 HR x 1 10 mEq IV over 1 HR x 5 AND Recheck serum potassium level 2 hours after infusion complete. 2.3-2.5 mEq/L 20 mEq IV over 2 HR x 3 10 mEq IV over 1 HR x 6 Recheck serum potassium level 2 hours after infusion complete <2.3 mEq/L Call Physician AND 20 mEq IV over 2 HR x 3 Call Physician AND 10 mEq IV over 1 HR x 6 Recheck serum potassium level 2 hours after infusion complete Sk . Adm 21 Page
Administration Oral: should be taken with meals and a full glass of water or other liquid to minimize the risk of Gl irritation. o Use parental potassium if: severe depletion (<2.5 mEq/L), NPO or cannot tolerate PO or EKG changes. (nausea/vomiting/diarrhea), . Parenteral: potassium must be diluted prior to parenteral administrations. For IV infusion, do not administer IV push... Clinical experts recommend that the maximum concentration for peripheral infusion is 10 mEq per 100 ml. The maximum rate of administration for peripheral infusion is 10 mEq/hour. With central line administration, higher concentrations and more rapid rates of infusion may be used. Concentrations of 20-40 mEq per 100ml at a maximum rate of 20 mEq/hour via central line have been safely administered. In emergency situations, maximum rate may be increased to 40 mEq/hour. Compatibility Compatible and preferred: NS, % NS • Compatible but NOT preferred: DSW . Standard concentrations: 10 mEq/50ml, 10 mEq/100ml, 20 mEq/50ml, and 20 mEq/100mL Monitoring Parameters . Normal serum potassium level: 3.6-5.0 mEq/L Careful monitoring of physiologic effects of severe hypokalemia and hyperkalemia is essential. Additionally, it's important to monitor of serum potassium every two to four hours to ascertain the response to therapy. Adverse Reactions Pain and phlebitis can occur when IV potassium is infused via peripheral lines. This primarily occurs at rates above 10 mEq/hour but can be seen at lower rates. If pain occurs, infusion rate or potassium concentration should be reduced. 31 as
Patient Care Skills Lab IV Sterile Products Worksheet Student Name: Date: 1. Mi is a 23-year-old, 54.5kg (120lbs), 170 cm (67 in) male with a history of alcoholism for 3 years. He has been sober for the past 2 years until the recent death of his father 6 months ago. Since then, he has been drinking daily and become more pessimistic about life. Recently, he decided to stop drinking to prove to his mother and his sister that he does not need alcohol. Today, he is brought into the ER by his mother who says that he has been vomiting since last night. Upon admission, he admits that he experiences abdominal pain, anxiety, tremors, nausea since last drink, and headache. His physical examination reveals pulse of 114, enlarged liver, tremors in fingers and hands. His lab results show Na 134, CI 101, Bicarb 23, SCr 0.8, Glucose 99, and K 3.1. Dr. G wanted to start him on IV potassium chloride to correct his potassium depletion. A peripheral line access is immediately started for MJ and electrolyte repletion protocol suggests the following dose: 1. Potassium chloride dose: mEq over HR x (# of doses) How many mL of potassium chloride will you need to withdraw from the vial to make this dose? _mL. (vial concentration of 2mEq/ml) 2. What size and type of IV bag do you need to make this product? 3. Rate of administration of dose (entire bag): _ml/hour 4. Calculate the flow rate in gtt per min if the drop factor for the infusion pump is 20 gtt per ml Flow rate: gtt/min (round to the nearest whole number)