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])

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