Nursing In Ghana

INTRAVENOUS FLUIDS: TYPES AND USES (PART 1)

NORMAL SALINE (NS)

DESCRIPTION

0.9% NaCl in Water

Crystalloid Solution

Isotonic (308 mOsm)

USES

  • Increases circulating plasma volume when red cells are adequate
  • Shock
  • Fluid replacement in patients with diabetic ketoacidosis
  • Hyponatremia
  • Blood transfusions
  • Resuscitation
  • Metabolic alkalosis
  • Hypercalcemia
  • Replaces losses without altering fluid concentrations.

PRECAUTIONS

  • Do not use in patients with heart failure, edema, or hypernatremia, because NS replaces extracellular fluid and can lead to fluid overload.

1/2 NORMAL SALINE (1/2 NS)

DESCRIPTION

  • 0.45% NaCl in Water
  • Crystalloid Solution
  • Hypotonic (154 mOsm

USES

  • Water replacement
  • Raises total fluid volume
  • DKA after initial normal saline solution and before dextrose infusion
  • Hypertonic dehydration
  • Sodium and chloride depletion
  • Gastric fluid loss from nasogastric suctioning or vomiting.
  • Useful for daily maintenance of body fluid, but is of less value for replacement of NaCl deficit.
  • Helpful for establishing renal function.

PRECAUTIONS

  • Use cautiously; may cause cardiovascular collapse or increase in intracranial pressure.
  • Don’t use in patients with liver disease, trauma, or burns
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LACTATED RINGER’S (LR) OR RINGER’S LACTATE (RL)

DESCRIPTION

  • Normal saline with electrolytes and buffer
  • Isotonic (275 mOsm)

USES

  • Replaces fluid and buffers pH
  • Hypovolemia due to thirdspace shifting.
  • Dehydration
  • Burns
  • Lower GI tract fluid loss
  • Acute blood loss

PRECAUTIONS

  • Don’t use in liver disease because the patient can’t metabolize lactate; a functional liver converts it to bicarbonate; don’t give if patient’s pH > 7.5.
  • Has potassium therefore don’t use to patients with renal failure as it can cause hyperkalemia

D5W  (5%DEXTROSE WATER) OR 5% DEXTROSE

DESCRIPTION

  • Dextrose 5% in water Crystalloid solution
  • Isotonic (in the bag)
  • *Physiologically hypotonic (260 mOsm) (the dextrose is metabolized quickly so that only water remains – a hypotonic fluid )

USES

  • Raises total fluid volume.
  • Helpful in rehydrating and excretory purposes.
  • Fluid loss and dehydration
  • Hypernatremia
  • Provides 170-200 calories/1,000cc for energy

PRECAUTIONS

  • Use in caution to patients with renal or cardiac disease, can cause fluid overload

Credit: nurseslabs

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Jude Arko

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