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Electrolyte Guide

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Potassium

Normal Range: 3.6-5.0 mEq/L

Hypokalemia:

Goal: in general >3.5, in cardiac patients >4.0; use caution when repleting in patients with renal dysfunction

If rechecking, do so 3 hours after dose

Level Oral IV
<3.3 Kdur 60mEq KCl 60mEq
3.3-3.5 Kdur 40mEq KCl 20mEq
3.6-4.0 Kdur 20mEq KCl 20mEq

Hyperkalemia:

Hyperkalemic emergency:

treat with rapidly acting therapies (calcium gluconate 1g IV, insulin IV + D50) and removal (dialysis, GI cation exchangers if no contraindication, diuretics)


Phosphorus

Oral: Phospha 250 neutral (Neutra-phos)

IV: Potassium/Sodium Phosphate 15mmol

Level Oral IV
<1.5 0.5mmol/kg sodium phos
1.5-2.0 Neutraphos 0.25mmol/kg 0.25mmol/kg sodium phos
2.1-2.4 0.15mmol/kg sodium phos

Magnesium

Goal > 2.0

Level IV
<1.0 Magnesium Sulfate 1g x 4 doses @ 1g/hr
1.0-1.4 Magnesium Sulfate 1g x 3 doses @ 1g/hr
1.5-2.0 Magnesium Sulfate 1g x 2 doses @ 1g/hr

Calcium

Replete if ionized Calcium < 1.0