iv fluids and solutions quick reference guide cheat sheet - nurseslabs
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IV Fluids and Solutions Quick Reference Guide Cheat Sheet - NurseslabsTRANSCRIPT
2/3/2016 IV Fluids and Solutions Quick Reference Guide Cheat Sheet Nurseslabs
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IV Fluids and Solutions Quick ReferenceGuide Cheat Sheet
By Matt Vera, RN Feb 8, 2012
2/3/2016 IV Fluids and Solutions Quick Reference Guide Cheat Sheet Nurseslabs
http://nurseslabs.com/ivfluidsolutionquickreferenceguidecheatsheet/ 2/7
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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
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(NS)
9% NaCl inWater
CrystalloidSolution
Isotonic (308mOsm)
Increases circulating plasma volume when redcells are adequate
ShockFluid replacement in
patients with diabeticketoacidosis
HyponatremiaBlood transfusionsResuscitationMetabolic AlkalosisHypercalcemia
Do not use in patients with heartfailure, edema, or hypernatremia,because NSS replaces extracellularfluid and can lead to fluid overload.
Replaces losses without alteringfluid concentrations.
Helpful for Na+ replacement
1/2 Normal Saline(1/2 NS)
45% NaCl inWater
CrystalloidSolution
Hypotonic(154 mOsm)
Water replacementRaises total fluid volumeDKA after initial normal
saline solution and beforedextrose infusion
Hypertonic dehydrationSodium and chloride
depletionGastric fluid loss from
nasogastric suctioning orvomiting.
Use cautiously; may causecardiovascular collapse or increase inintracranial pressure.
Don’t use in patients with liverdisease, trauma, or burns.
Useful for daily maintenance ofbody fluid, but is of less value forreplacement of NaCl deficit.
Helpful for establishing renalfunction.
Fluid replacement for clients whodon’t need extra glucose (diabetics)
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Lactated Ringer’s(LR)
Normal salinewithelectrolytes andbuffer
Isotonic (275mOsm)
Replaces fluid and bufferspH
Hypovolemia due to third-space shifting.
DehydrationBurnsLower GI tract fluid lossAcute blood loss
Has similar electrolyte content withserum but doesn’t containmagnesium.
Has potassium therefore don’t useto patients with renal failure as it cancause hyperkalemia
Don’t use in liver disease becausethe patient can’t metabolize lactate; afunctional liver converts it tobicarbonate; don’t give if patient’s pH> 75.
Normal saline with K+, Ca++, andlactate (buffer)
Often seen with surgery
D W
Dextrose 5%in waterCrystalloidsolution
Isotonic (inthe bag)
*Physiologicallyhypotonic (260mOsm)
Raises total fluid volume.Helpful in rehydrating and
excretory purposes.
Fluid loss anddehydration
Hypernatremia
Solution is isotonic initially andbecomes hypotonic when dextrose ismetabolized.
Not to be used for resuscitation;can cause hyperglycemia
Use in caution to patients withrenal or cardiac disease, can causefluid overload
Doesn’t provide enough dailycalories for prolonged use; may causeeventual breakdown of protein.
Provides 170-200 calories/1,000ccfor energy.
Physiologically hypotonic -thedextrose is metabolized quickly sothat only water remains – a hypotonicfluid
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D NS
Dextrose 5%in 0.9% saline
Hypertonic(560 mOsm)
Hypotonic dehydrationReplaces fluid sodium,
chloride, and calories.Temporary treatment of
circulatory insufficiency andshock if plasma expandersaren’t available
SIADH (or use 3% sodiumchloride).
Addisonian crisis
Do not use in patients with cardiacor renal failure because of danger ofheart failure and pulmonary edema.
Watch for fluid volume overload
D 1/2 NS
Dextrose 5%in 0.45% saline
Hypertonic(406 mOsm)
DKA after initial treatmentwith normal saline solutionand half-normal salinesolution – preventshypoglycemia and cerebraledema (occurs when serumosmolality is reducedrapidly).
In DKA, use only when glucose falls< 250 mg/dl
Most common postoperative fluidUseful for daily maintenance of
body fluids and nutrition, and forrehydration.
D LR
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Dextrose 5%in LactatedRinger’s
Hypertonic(575 mOsm)
Same as LR plus providesabout 180 calories per1000cc’s.
Indicated as a source ofwater, electrolytes andcalories or as an alkalinizingagent
Contraindicated in newborns (≤ 28days of age), even if separate infusionlines are used (risk of fatalceftriaxone-calcium salt precipitationin the neonate’s bloodstream).
Contraindicated in patients with aknown hypersensitivity to sodiumlactate.
Normosol-R
NormosolIsotonic (295
mOsm)
Replaces fluid and bufferspH
Indicated for replacementof acute extracellular fluidvolume losses in surgery,trauma, burns or shock.
Used as an adjunct torestore a decrease incirculatory volume inpatients with moderateblood loss
Not intended to supplanttransfusion of whole blood or packedred cells in the presence ofuncontrolled hemorrhage or severereductions of red cell volume
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You can also grab a copy of the table above! We recommend printing this in a Letter-sized paper (8.5
by 11 inches (216 mm x 279 mm).
IV Cheat Sheet Color.pdfIV Cheat Sheet Mono.pdfIV Cheat Sheet (Old Version).docx
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Matt Vera, RNhttp://nurseslabs.com
Matt Vera is a registered nurse and one of the main editors for Nurseslabs.com. Enjoys health technology and innovations
about nursing and medicine, in general.