Fluid and Electrolyte Balance

0.9% Sodium Chloride (Normal Saline)

Isotonic; for hypervolemia, metabolic alkalosis, hyponatremia, and hypochloremia

0.45% Sodium Chloride (1/2-Normal Saline)

Hypotonic; for hypernatremia

0.33% Sodium Chloride (1/3-Normal Saline)

Hypotonic; for hypernatremia

Lactated Ringer’s (LR)

Isotonic, for hypovolemia, burns, and GI fluid loss

D5LR (5% Dextrose in Lacted Ringer’s)

Hypertonic in the bag; replaces electrolytes and expands vascular volume

Infiltration

Cool, swollen IV site; sluggish infusion

Phlebitis

Red, warm, swollen IV site

Speed Shock

Headache, rapid pulse, chills, dyspnea

Circulatory Overload

Dyspnea, dry cough, pulmonary edema

Hyponatremia

<135 mEq/L; cells swell; symptoms: headache, confusion, lethargy, nausea

Hypernatremia

>145 mEq/L; cells shrink; symptoms: thirst, weakness, confusion

Hypokalemia

<3.5 mEq/L; caused by GI losses and diuretics; symptoms: muscle weakness, fatigue, constipation, dysrhythmias

Hyperkalemia

>5.0 mEq/L; caused by kidney dysfunction; certain meds; symptoms: muscle weakness, paresthesia, dysrhythmias

Sodium

135-145 mEq/L; regulates ECF volume; loss or gain accompanied by loss or gain of water

Potassium

3.5-5.0 mEq/L; controls intracellular osmolality, regulator of enzyme activity

Calcium

8.5-10.5 mg/dL; role in blood coagulation and transmission of nerve impulses, helps regulate muscle contract/relax

Magnesium

1.7-2.2 mg/dL; Metabolism of carbs and proteins, neuromuscular role