Oral Fluid Replacement

Oral Fluid Replacement

• Used to correct mild fluid and electrolyte deficits
  • Water
  • Glucose
  • Potassium
  • Sodium

IV Fluids

• Purposes
  • Maintenance
    • When oral intake is not adequate
  • Replacement
    • When losses have occurred
• Types of fluids categorized by tonicity
  • Hypotonic
    • More water than electrolytes
    • Pure water lyses RBCs
    • Water moves from ECF to ICF by osmosis
    • Usually maintenance fluids
    • Monitor for changes in mentation
  • Isotonic
    • Expands only ECF
    • No net loss or gain from ICF
    • Ideal to replace ECF volume deficit
      • D₅W
        • 5% Dextrose (sugar) in Water
        • Free water without electrolytes
        • Provides 170 cal/L
        • Used to replace water losses, treat hypernatremia, prevent ketosis
      • Normal Saline (NS or NSS)
        • More NaCl than ECF
        • No free water, calories or electrolytes
        • Expands IV volume
          • Preferred fluid for immediate response
        • Compatible with most medications
        • Only solution used with blood
      • Lactated Ringer’s Solution
        • Similar in composition to plasma  except contains no magnesium
        • Expands ECF—treat burns and GI losses
        • Contraindicated with hyperkalemia and lactic acidosis
        • No free water or calories
  • Hypertonic
    • Initially expands and raises the osmolality of ECF
    • Require frequent monitoring of
      • Blood pressure
      • Lung sounds
      • Serum sodium levels

• • • • D₅ NS
        • 5% Dextrose and 0.45% Sodium Chloride Injection
        • Common maintenance fluid
        • Replaces fluid loss
        • KCl added for maintenance or replacement
      • D₁₀W
        • Dextrose 10 % in Water
        • Provides 340 kcal/L
        • Provides free water but no electrolytes
        • Limit of dextrose concentration may be infused peripherally
  • Colloids
    • Stay in vascular space and increase osmotic pressure
    • Include:
      • Human plasma products (albumin, fresh frozen plasma, blood)
      • Semisynthetics (dextran and starches, [Hespan])