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Supportive literature for limiting Peripheral IV KCL concentrations
I am having difficulty locating supportive literature for limiting IV KCL Peripheral for riders or primary IVF.  It has been our institutions P&P to limit peripheral IV KCL in 1L bags to 80 mEq and riders to no greater than 10 meq/100 ml IVF.  Our cardiologists specifically are challenging me and our pharmacy.  They are writing orders for up to 20 mEq/100 ml or 40 mEq/250 ml of IVF on cardiac patients that they are limiting fluids on.  This is an overall concentration of 160 - 200 mEq/L which I continue to find unacceptable peripherally.  I am siting our INS Practice & Principles as well as INS P&P guidelines with no avail.  The physicians are looking for additional supportive literature from their colleagues - they feel our practice is outdated.  Any thoughts?
You will have to go farther
You will have to go farther than the INS references to satisfy most physicians, primarily because most have no or very little respect for nursing standards and research. You will need to educate them about the pH and osmolarity of these fluids and then find the literature on what those pH and osmolarity levels actually do to venous endothelium. pH of 4.5 has been shown to produce phlebitis in 100% of cases. Osmolarity causes fluid shifting and results in phlebitis and thormbosis. Good luck Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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