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How to Select Right Intravenous Solutions | Facts and Understanding

Intravenous fluids are very essential in maintaining fluid balance. This fluids are intended to be administered directly through the system. IV fluids comes in different types and the usage depends upon the body need. Usually, fluids are given when there is a drop in bodily fluid volume like dehydration. Also fluids are used to restore electrolytes in the body, and use as a means in giving medications.

Like i said, the administration of the solution depends upon the patients condition. Giving the wrong solution can make the patients condition more worse.
Below is a guide in giving or knowing the right intravenous fluid for the patients condition.

Solutions: Dextrose 2.5%, 5%, 10%, 20%,, 50%, 70%
Osmolarity: Hypotonic, Isotonic, Hypertonic
Indications: Spares body protein. Provides calories. Provides free water. Acts as a diluent for IV drugs. Treats dehydration. Treats hyperkalemia.
Precautions: Possible compromise of glucose tolerance. Does not provide any electrolytes. May cause vein irritation, water intoxication. Hypertonic solutions may cause hyperglycemia, osmotic diuresis.

Solutions: Sodium Choride 0.25%, 0.45% half strength, 0.9% full strength, 3%, 5%
Osmolarity: Hypotonic, Isotonic, Hypertonic
Indications: Replaces ECF and electrolytes. Replaces sodium and chloride. Treats hyperosmolar diabetes. Acts as diluent for IV drugs. Used to initiate blood products. Replaces severe sodium and chloride deficits. Irrigant for intravascular devices.
Precautions: Hyponatremia; calorie depletion; hypernatremia or hyperchloremia; circulatory overload; deficit of other electrolyte. Can induce hyperchloremic acidosis due to loss of bicarbonate ions. Does not provide free water or calories.

Solutions: Hydrating Solutions 5% D/0.25% NaCl 5%, D/0.45%, NaCl 5% D/0.9% NaCl
Osmolarity: Isotonic, Hypertonic
Indications: Assess kidney function. Hydrate cells. Promote diuresis. Supply some calories. Reduce nitrogen depletion. Used as plasma expander
Precautions: Use with caution in patients with edema and those with cardiac, renal, or liver disease.. Do not use in patients allergic to corn.

Solutions: Multiple Electrolyte Lactated Ringer’s 5% D/LR
Osmolarity: Isotonic, Hypertonic
Indications: Treats mild metabolic acidosis. Replaces fluid losses from burns and trauma. Replaces fluid losses from alimentary tract. Rehydrates in all types of dehydration
Precautions: Contraindicated in patients with lactic acidosis. Circulatory overload

Solutions: Plasma Expanders Dextran 70 (6%) in water; Dextran 40 (10%) in water
Osmolarity: Isotonic
Indications: Provides plasma expansion. Treats shock. Prevents venous thrombosis during surgery
Precautions: Hypersensitivity reactions. Increased risk of bleeding. *Do not add any medications to dextran solutions.

Solutions: 10% Mannitol, 20% Mannitol
Osmolarity: Hypertonic
Indications: Reduces introcular pressure, reduces cerebral edema. Promotes diuresis of toxic substances
Precautions: Hypervolemia, Extravasation, Skin irritation, Tissue necrosis Interferes with laboratory testing.

Solutions: 5% Albumin, 25% Albumin
Indications: Restores circulatory dynamics. Counteracts shock. Provides protein. Treats hyperbilirubinemia
Precautions: Allergic reactions, Circulatory overload, Alteration in laboratory tests, Due to heat during preparation, viral disease transmission is eliminated.
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