Electrolyte replacement

Electrolyte replacement

Drug monograph · NCLEX study reference
Therapeutic class	Electrolyte replacement
Pharmacologic class	Electrolyte salts
Onset / peak / duration	Oral slower; IV faster (must be controlled).
Half-life / level	Targeted to normal serum ranges.
Routes	IV
High-alert (ISMP)	Yes (IV potassium chloride and IV magnesium)
Black box warning	None
Antidote / reversal	Calcium for magnesium toxicity; insulin and dextrose and other measures for hyperkalemia.
Pregnancy / lactation	Used as needed.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Electrolyte replacement — Electrolyte replacement; Electrolyte salts.

Identification

• Therapeutic class: Electrolyte replacement.
• Pharmacologic class: Electrolyte salts.

Pharmacology

• Mechanism of action: Replace deficient electrolytes to restore normal physiology.
• Onset / peak / duration: Oral slower; IV faster (must be controlled).
• Half-life / therapeutic level: Targeted to normal serum ranges.

Clinical use

• Indications: Hypokalemia (potassium), hypomagnesemia (magnesium), hypocalcemia and emergencies (calcium), acidosis (bicarbonate), hypophosphatemia (phosphate).
• Usual dose, route, frequency: Oral or IV; IV potassium always diluted and infused slowly via a pump.
• Maximum dose / adjustments: IV potassium never given by IV push and not faster than about 10 mEq/hr peripherally; adjust for renal function.

Safety

• Contraindications: Potassium in hyperkalemia or significant renal failure; calcium with caution in digoxin toxicity.
• Black box warning: None.
• Interactions: Potassium with ACE inhibitors, ARBs, potassium-sparing diuretics, and salt substitutes (hyperkalemia).
• Pregnancy / lactation: Used as needed.
• High-alert: Yes (IV potassium chloride and IV magnesium).

Adverse effects

• Common side effects: Oral potassium GI upset; infusion-site burning with IV potassium.
• Serious effects to report: Cardiac arrhythmias from too-fast potassium or hyperkalemia, magnesium toxicity (loss of reflexes, respiratory depression), calcium extravasation.
• Antidote / reversal: Calcium for magnesium toxicity; insulin and dextrose and other measures for hyperkalemia.

Nursing process

• Assessment before administration: Serum level, renal function, ECG, urine output, IV site.
• Interventions during therapy: Always dilute IV potassium and use a pump (never push); monitor ECG; give oral potassium with food and full water; check renal function and urine output first.
• Monitor: Serum electrolytes, ECG, renal function, IV site, reflexes (magnesium).
• Evaluation / expected outcome: Corrected electrolyte level.

Patient teaching

• Patient teaching: Take oral potassium with food and a full glass of water; do not crush extended-release potassium; report palpitations.
• Notify provider if: Palpitations, muscle weakness, IV-site pain, decreased urination.
• Administration tips: IV potassium always diluted and pumped, never pushed; high-alert double-check.