Hypermagnesemia 83
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-KCL 40 mEq PO tid (in addition to IV); max total dose 100-200 mEq/d (3
mEq/kg/d).
Chronic Therapy:
-KCL elixir 1-3 tablespoon qd-tid PO after meals (20 mEq/Tbsp of 10% sln)
OR
-Micro-K 10 mEq tabs 2-3 tabs PO tid after meals (40-100 mEq/d) OR
-K-Dur 20 mEq tabs 1 PO bid-tid.
Hypokalemia with metabolic acidosis:
-Potassium citrate 15-30 mL in juice PO qid after meals (1 mEq/mL).
-Potassium gluconate 15 mL in juice PO qid after meals (20 mEq/15 mL).
9. Extras: ECG, dietetics consult.
10. Labs: CBC, magnesium, SMA 7&12. UA, urine Na, pH, 24h urine for K,
creatinine.
Hypermagnesemia
1. Admit to:
2. Diagnosis: Hypermagnesemia
3. Condition:
4. Vital signs: q6h. Call physician if QRS >0.14 sec.
5. Activity: Up ad lib
6. Nursing: Inputs and outputs, daily weights.
7. Diet: Regular
8. Special Medications:
-Saline diuresis 0.9% saline infused at 100-200 cc/h to replace urine loss
AND
-Calcium chloride, 1-3 gm added to saline infusate (10% sln; 1 gm per 10 mL
amp) to run at 1 gm/hr AND
-Furosemide (Lasix) 20-40 mg IV q4-6h as needed.
-Magnesium of >9.0 requires stat hemodialysis because of risk of respiratory
failure.
9. Extras: ECG
10. Labs: Magnesium, calcium, SMA 7&12, creatinine. 24 hour urine
magnesium, creatinine.
Hypomagnesemia
1. Admit to:
2. Diagnosis: Hypomagnesemia
3. Condition:
4. Vital signs: q6h
5. Activity: Up ad lib
6. Diet: Regular
7. Special Medications:
-Magnesium sulfate 4-6 gm in 500 mL D5W IV at 1 gm/hr. Hold if no patellar
