Intravenous (IV) potassium therapy is a treatment for severe hypokalemia, which is when a patient has dangerously low potassium levels in the blood. Because intravenous administration of potassium can potentially be dangerous for patients, this treatment is only recommended when it is clearly clinically indicated and there are several safeguards used to reduce the risks to the patient. Typically, IV potassium is provided in a hospital setting, often an intensive care unit, and the patient is monitored carefully for any signs of complications.
Potassium plays a key role in a number of physiological functions, including communication between the nerves and regulation of the heartbeat. Many people get adequate potassium from their diets. If someone is not eating a balanced diet, is taking a medication that interferes with potassium absorption or retention, or is expressing potassium at a rate faster than it is being consumed, he or she can develop hypokalemia. In the mild stages, the patient may have limited symptoms. As the potassium deficiency continues, the patient can develop kidney problems, muscle paralysis, and heart arrhythmias.
Low potassium can be diagnosed with a blood test to check the levels of this mineral in the patient. For mild to moderate cases, oral supplementation may be recommended. Once the patient is stabilized, treatment of the underlying causes can begin. In severe cases or cases where a patient cannot tolerate oral medications, IV potassium therapy may be recommended.
The risk with IV potassium is that the body cannot process this mineral well in large amounts. If the blood is flooded with a bolus of potassium, there is a risk that it can stop the heart. In fact, potassium chloride is used in executions, illustrating how lethal it can be in larger doses. When IV potassium is administered, it is diluted and set on an infusion pump to regulate how quickly it enters the body. The patient is also monitored for signs of distress like arrhythmias or chest pain.
Many hospitals have specific policies about IV potassium administration that people must follow when giving this treatment. The policies are designed to reduce the risk of medication errors and keep patients safe. Since the therapy is often administered by a nurse, nurses are expected to be familiar with the policy and if they receive orders that contradict the policy or seem dangerous, nurses can question the orders and request clarification. Acting as advocates for patients, nurses can refuse to comply with orders that will endanger a patient until the orders are rewritten.
