NAVLE® Question of the day

A 20-kg mixed breed female spayed dog is presented with a history of vomiting and diarrhea of two days' duration. Bloodwork identifies severe hypokalemia of 1.8 mEq/L (normal = 3.9-5.1 mEq/L).

The dog is showing signs of generalized muscle weakness. ECG identifies atrial premature contractions .

You start the dog on intravenous fluids administered at 100 mL/h. 

What is the maximum amount of potassium chloride (concentration = 2 mEq/mL) to safely add to a 1-L bag of 0.9% NaCl for this patient at this fluid rate? (Note: you need to remove the same volume of NaCl from the bag first to match the volume of KCl you add so the total volume in the bag remains 1000 ml.)

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