4 Common IV Fluids a Nurse Should KnowHigher Education Articles October 12, 2013
Nurses have an obligation to recognize and understand the purpose of the most common IV (intravenous fluids) fluids used to treat patients. Intravenous fluids are routinely used in outpatient and inpatient settings, as part of a medical regime to promote or restore good health. These chemical solutions are used to keep the body hydrated, transport oxygen through the bloodstream and as a vehicle to administer antibiotics.
Doctors prescribed IV therapy based on patient symptoms, treatment plans and medical condition. A nurse normally monitors the rate of fluid delivery, the IV site to be sure the medication is flowing properly and the patient’s response to therapy.
Approximately 60% of normal body weight is attributed to water. According to a May 2011 article, written by Ann Crawford PhD, RN and Helene Harris MSN, RN for Nursing titled IV Fluids What Nurses Need to Know; older people tend to have a lower percentage of body fluid while young children can have as much as 80% volume. Their article also states that adipose tissue has lower water volume than healthy lean muscle.
Understanding the significance of maintaining balanced, fluid levels accentuates the necessity of becoming familiar with the intended purposes of the most common IV fluids and their chemical compositions. This knowledge helps to ensure nurses are prepared to identify any problems that arise during treatment and take appropriate action.
These solutions have large proteins and other molecules that remain in the blood vessels rather than being absorb outside the vascular space. Although colloids are expensive, these solutions are highly effective in maintaining proper blood volume since they tend to remain in the blood vessels.
For protein replacement, one of the most common IV fluids is albumin solution. This mixture comes in either 5% or 25% concentration and is used to treat shock symptoms. Caution should be used when administering an albumin solution since pulmonary edema and fluid overload may develop in some patients. An additional concern is the potential for an anaphylaxis. Both colloid and crystalloid solutions have many uses and potential reactions.
The third on the list of most common IV fluids is a class called colloid solutions. These mixtures contain electrolytes and are used to replenish body fluids or achieve a balanced electrolyte level which was compromised due to poor nutrition or disease.
The percentage of electrolyte to sterile water determines if the IV fluid is hypotonic (contained a lower concentration of electrolytes than blood plasma) or hypertonic (containing a higher concentration of electrolytes than normal blood plasma).
The solution is also called LR, RL and Lactated Ringer’s. The chemical composition is primarily sterile water and a mixture of soluble sodium chloride, calcium chloride, potassium chloride and sodium lactate. Ringer’s Lactate is an example of an isotonic cystalloid solution.
•Normal Saline Solution
Another example of a cystalloid solution is normal saline. The saline concentration is 9% for this solution which is often administered in the ambulance during transport and to support proper fluid levels.
•5% Dextrose in Water
Another of the most common IV fluids, D5W, is a carbohydrate solution. The composition is 5% glucose dissolved in sterile water. This isotonic solution is converted to a hypotonic solution in the body and is quickly metabolized once it is introduced to the body.
Blood and Blood Products
Blood and blood products are administered intravenously. Replenishing blood lost due to accident or illness with blood products is the best solution because they naturally carry oxygen to the body. However, blood is a precious commodity and is not always available.
These synthetic (man-made) solutions are used when whole blood or blood products are not readily available or when medical providers deem necessary to facilitate oxygen delivery through IV solution alternatives.
Although these products are still in the experimental stage, researchers and medical providers are hopeful that these solutions will be added to the list of most common IV fluids, if they are able to mimic blood by carrying oxygen throughout the body, to counter the effects of severe blood loss or hypovolemia.
Intravenous therapy is useful for treating many disorders and managing patient vitals during surgery. Learning about the various fluids is crucial to providing patients with quality care.