IV Fluids and Solutions Quick Reference Guide Cheat Sheet

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Intravenous solutions are used in fluid replacement therapy by changing the composition of the serum by adding fluids and electrolytes. Listed below is a table which may serve as your quick reference guide on the different intravenous solutions.
Type
Use
Special Considerations
Normal Saline (NS)
  • 9% NaCl in Water
  • Crystalloid Solution
  • Isotonic (308 mOsm)
  • Increases circulating  plasma volume when red cells are adequate
  • Shock
  • Fluid replacement in patients with diabetic ketoacidosis
  • Hyponatremia
  • Blood transfusions
  • Resuscitation
  • Metabolic Alkalosis
  • Hypercalcemia
  • Do not use in patients with heart failure, edema, or hypernatremia, because NSS replaces extracellular fluid and can lead to fluid overload.
  • Replaces losses without altering fluid concentrations.
  • Helpful for Na+ replacement
1/2 Normal Saline (1/2 NS)
  • 45% NaCl in Water
  • Crystalloid Solution
  • Hypotonic (154 mOsm)
  • 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.
  • Use cautiously; may cause cardiovascular collapse or increase in intracranial pressure.
  • Don’t use in patients with liver disease, trauma, or burns.
  • Useful for daily maintenance of body fluid, but is of less value for replacement of NaCl deficit.
  • Helpful for establishing renal function.
  • Fluid replacement for clients who don’t need extra glucose (diabetics)
Lactated Ringer’s (LR)
  • Normal saline with electrolytes and buffer
  • Isotonic (275 mOsm)
  • Replaces fluid and buffers pH
  • Hypovolemia due to third-space shifting.
  • Dehydration
  • Burns
  • Lower GI tract fluid loss
  • Acute blood loss
  • Has similar electrolyte content with serum but doesn’t contain magnesium.
  • Has potassium therefore don’t use to patients with renal failure as it can cause hyperkalemia
  • 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.
  • Normal saline with K+, Ca++, and lactate (buffer)
  • Often seen with surgery
D5W
  • Dextrose 5% in water Crystalloid solution
  • Isotonic (in the bag)
  • *Physiologically hypotonic (260 mOsm)
  • Raises total fluid volume.
  • Helpful in rehydrating and excretory purposes.
  • Fluid loss and dehydration
  • Hypernatremia
  • Solution is isotonic initially and becomes hypotonic when dextrose is metabolized.
  • Not to be used for resuscitation; can cause hyperglycemia
  • Use in caution to patients with renal or cardiac disease, can cause fluid overload
  • Doesn’t provide enough daily calories for prolonged use; may cause eventual breakdown of protein.
  • Provides 170-200 calories/1,000cc for energy.
  • Physiologically hypotonic -the dextrose is metabolized quickly so that only water remains - a hypotonic fluid
D5NS
  • Dextrose 5% in 0.9% saline
  • Hypertonic (560 mOsm)
  • Hypotonic dehydration
  • Replaces fluid sodium, chloride, and calories.
  • Temporary treatment of circulatory insufficiency and shock if plasma expanders aren’t available
  • SIADH (or use 3% sodium chloride).
  • Addisonian crisis
  • Do not use in patients with cardiac or renal failure because of danger of heart failure and pulmonary edema.
  • Watch for fluid volume overload
D5 1/2 NS
  • Dextrose 5% in 0.45% saline
  • Hypertonic (406 mOsm)
  • DKA after initial treatment with normal saline solution and half-normal saline solution -prevents hypoglycemia and cerebral edema (occurs when serum osmolality is reduced rapidly).
  • In DKA, use only when glucose falls < 250 mg/dl
  • Most common postoperative fluid
  • Useful for daily maintenance of body fluids and nutrition, and for rehydration.
D5LR
  • Dextrose 5% in Lactated Ringer’s
  • Hypertonic (575 mOsm)
  • Same as LR plus provides about 180 calories per 1000cc’s.
  • Indicated as a source of water, electrolytes and calories or as an alkalinizing agent
  • Contraindicated in newborns ((≤ 28 days of age), even if separate infusion lines are used (risk of fatal ceftriaxone-calcium salt precipitation in the neonate’s bloodstream).
  • Contraindicated in patients with a known hypersensitivity to sodium lactate.
Normosol-R
  • Normosol
  • Isotonic (295 mOsm)
  • Replaces fluid and buffers pH
  • Indicated for replacement of acute extracellular fluid volume losses in surgery, trauma, burns or shock.
  • Used as an adjunct to restore a decrease in circulatory volume in patients with moderate blood loss
  • Not intended to supplant transfusion of whole blood or packed red cells in the presence of uncontrolled hemorrhage or severe reductions of red cell volume


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notes.nursium.com: IV Fluids and Solutions Quick Reference Guide Cheat Sheet
IV Fluids and Solutions Quick Reference Guide Cheat Sheet
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