Thursday, March 15, 2007

// Tips // Administering Potassium Chloride

A one-year old infant died in a Batangas hospital after a student nurse allegedly committed an error in the administration of potassium chloride.

Based on reports, the student nurse allegedly infused potassium chloride to the infant, who was hospitalized due to severe diarrhea, directly through the baby's IV line, instead of mixing it with a saline solution.

Here is a video report (in Filipino) by GMA 7 of the incident:
Child dies due to wrong injection

Potassium chloride, if administered improperly, can lead to sudden cardiac arrest. Here are some tips to remember when administering this drug:

Potassium chloride causes an increase in intracellular potassium shifting that is why it is never administered directly into an IV line. Doing so would lead a cardiac arrest. Diluting the drug in normal saline is the recommended administration, if it is being given intravenously, and a pump or controller is used to control its flow. Potassium chloride is never given by bolus infusion because its effects are felt immediately. The recommended concentration for potassium chloride is only 20 to 40 mEq/L or no more than 10 to 20 mEq/hour. The solution containing the potassium chloride is gently turned over to ensure the drug has been diluted well.

Potassium chloride is irritating to the veins so the infusion site is monitered for phlebitis. After infusion, monitor the patient's heart rate and rhythm. If a client is receiving digitalis, potassium chloride increases its toxicity. Administer oral potassium with food or fluid to lessen gastric irritation.

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Anonymous said...

Questions re NCLEX

1. Do I need to have an employer first before taking the NCLEX?

2. Please give me the step by step procedure in registering for NCLEX. State of choice is Chicago, Illinois.

3. Any idea re start of NCLEX site operation in the Philippines?

Geoff said...

The NCLEX is similar to our local licensure exam. Passing the NCLEX would lead you to get a license, similar to the local exams which if you pass you'll get a nursing license, provided of course, you meet the other requirements for licensure. In the local exams, we need to submit proof of education and clinical duties, and others. In the US, they also have their own requirements and these requirements vary from state to state.

First of all, you don't need an employer to apply for a state board of nursing in the US and sit for the NCLEX exam. Applying for a licensure in the US is not cheap, you'll be spending at least $600 or more. That's why some people go through an agency because the agency will shoulder this cost for you while you're not yet working. However, don't forget that whatever they pay in your behalf will be reimbursed to them, at an interest, later on, either from your salary or through an arrangement with your employer. Also, signing up with an agency means you'll be signing a contract with them and you won't be able to get out of it. There are many horror stories regarding bad agencies so be very careful when choosing an agency, if you feel this is for you.

But, as I've said, you don't need an agency to apply. Even agencies require you to take the CGFNS exam, which already costs over $400, even you don't really need it anymore. If you have the money to pay for the application yourself, I suggest you apply on your own.

To apply for a license in Illinois, you need to complete:
1) a CES report. go to and download an application form;
2) if your school's medium of instruction is not English, then take the TOEFL iBT exam. However, since most of the schools in the Philippines use English, you may be exempted here. Check with your registrar first.
3) go to the Illinois Dept of Financial and Professional Regulation Web site and in the Nursing section, download an application form.
4) E-mail them to request a fingerprint card, which you'll need to process with the local NBI and then sent to Integrated Biometric Technology.

I can guide you as you complete each step. Check with the Web sites that I've mentioned first and contact me if you have specific questions.

Geoff said...

Let me correct the URL i gave you. The Illinois professional regulation site should be

To guide you with your application, download this form:

Anonymous said...

Thanks Geoff, indeed a big help. Will just post my other questions as I go on with the application. Referred your site to other friends, ok lang ba?

Geoff said...

You're welcome. I'll try to answer your questions as best as I can or point you to people who can also help you out.

Yes, please do ask your friends to visit. Thanks.

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