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
- Maintenance
- 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
- D5W
- Hypertonic
- Initially expands and raises the osmolality of ECF
- Require frequent monitoring of
- Blood pressure
- Lung sounds
- Serum sodium levels
- Hypotonic
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- 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
- D5 NS
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- Colloids
- Stay in vascular space and increase osmotic pressure
- Include:
- Human plasma products (albumin, fresh frozen plasma, blood)
- Semisynthetics (dextran and starches, [Hespan])
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