- Body system
- Fluids and electrolytes
- Drug cards
- 2 in this guide
Drugs in this class
Other examples: Calcium gluconate, Calcium chloride, Sodium bicarbonate, Potassium phosphate, Magnesium oxide.
How electrolyte replacements work
Replace electrolytes needed for heart rhythm, nerve conduction and muscle contraction.
Uses
- Hypokalemia
- Hypomagnesemia and torsades de pointes
- Seizure prevention in preeclampsia (magnesium sulfate)
- Hypocalcemia and hyperkalemia cardiac protection (calcium)
Adverse effects
- Hyperkalemia and dysrhythmias
- IV site pain and phlebitis
- Magnesium toxicity: loss of reflexes, respiratory depression, hypotension
Nursing considerations
- Never give potassium IV push or IM. Use an infusion pump and follow the facility's rate and concentration limits.
- Check kidney function and urine output before replacing potassium or magnesium.
- Keep calcium gluconate at the bedside during magnesium sulfate infusions.
Patient teaching
- Take oral potassium with food and water.
- Report muscle weakness, palpitations or numbness.
Electrolyte replacements NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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Which order for potassium chloride should the nurse question?
Show answer
Answer C: 20 mEq IV push IV push potassium can cause cardiac arrest. Potassium is always diluted and infused.
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During a magnesium sulfate infusion, the patient's patellar reflexes are absent. What should the nurse do?
Show answer
Answer B: Stop the infusion and notify the provider Loss of deep tendon reflexes is an early sign of magnesium toxicity.
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Which medication should be at the bedside during a magnesium sulfate infusion?
Show answer
Answer B: Calcium gluconate Calcium gluconate is the antidote for magnesium toxicity.
Frequently asked questions
What are electrolyte replacements?
Potassium and magnesium replacements are high-alert medications. IV potassium is never pushed, and magnesium sulfate toxicity shows first as lost reflexes.
How do electrolyte replacements work?
Replace electrolytes needed for heart rhythm, nerve conduction and muscle contraction.
What are examples of electrolyte replacements?
Potassium chloride, Magnesium sulfate, Calcium gluconate, Calcium chloride, Sodium bicarbonate, Potassium phosphate and Magnesium oxide.
What are the nursing considerations for electrolyte replacements?
Never give potassium IV push or IM. Use an infusion pump and follow the facility's rate and concentration limits. Check kidney function and urine output before replacing potassium or magnesium.