CLASS: crystalloids
NAME: 0.9% NaCl sodium chloride (normal saline), lactated ringers
USES: given to treat dehydration
SIDE EFFECTS:
-edema
-fluid overload
-reduced colloid oncotic pressure
INTERACTIONS: very rare
NURSING CONSIDERATIONS: assess for edema
ROUTES OF ADMINISTRATION: IV injection
CLASS:
colloids
NAME: albumin, dextran, and hetastarch.
USES: Increase the colloid oncotic pressure and moves fluid from the interstitial compartment to the plasma compartment by pulling the
fluid into the blood vessels. Increase the blood volume, and they are sometimes called plasma expanders.
SIDE EFFECTS: They can alter the coagulation system through a dilutional effect, which results in impaired coagulation and possibly
bleeding. Rarely, dextran therapy causes anaphylaxis or renal failure.
INTERACTIONS: no drug interactions
NURSING CONSIDERATIONS: Contraindications to the use of colloids include known drug allergy to a specific product and
hypervolemia and may include severe electrolyte disturbance.
ROUTES OF ADMINISTRATION: IV injection
CLASS: potassium
NAME:
- IV administration are acetate, chloride, and phosphate.
- acetate, bicarbonate, chloride, citrate, and gluconate salts of potassium are available for oral administration
USES: They are used to treat hypokalemia caused by diuretics, poor diet, or illnesses.
SIDE EFFECTS:
- Contraindications to potassium replacement products include known allergy to a specific drug product, hyperkalemia from any cause,
severe renal disease, acute dehydration, untreated Addison disease, severe hemolytic disease, and conditions involving extensive tissue
breakdown (e.g., multiple trauma, severe burns).
INTERACTIONS: Concurrent use of potassium-sparing diuretics and ACE inhibitors can produce a hyperkalemic state. Concurrent
use of non–potassium-sparing diuretics, amphotericin B, and mineralocorticoids can produce a hypokalemic state.
NURSING CONSIDERATIONS: assess labs for potassium to make sure that the patient isn’t hyper/hypokalemic
ROUTES OF ADMINISTRATION: IV injection, tablets, solutions, elixirs, and powders
CLASS: sodium polystyrene
NAME: Kayexalate
USES: a cation exchange resin and is used to treat hyperkalemia.
SIDE EFFECTS:
- Hypernatremia
- Hypokalemia
- Hypocalcemia
- Hypomagnesemia
- Nausea
- Vomiting
INTERACTIONS:
- antacids and laxatives
- sorbitol with Kayexalate has been implicated in cases of intestinal colonic necrosis.
NURSING CONSIDERATIONS:
- Assess bowel movements: Kayexalate should not be used in patients who do not have normal bowel function and should be
discontinued in patients who develop constipation.
ROUTES OF ADMINISTRATION: It is usually administered orally via nasogastric tube or as an enema.
Sodium
BRAND NAME: Salt, Sodium Chloride
USES: Sodium is the major cation in ECF and is involved in the control of water distribution, fluid and electrolyte balance, and osmotic
pressure of body fluids. Sodium also participates in the regulation of acid base balance. Chloride, the major ECF anion closely
complements the physiologic action of sodium. Used for the treatment or prevention of sodium depletion.
ADVERSE EFFECTS: The oral administration of sodium chloride can cause gastric upset consisting of nausea, vomiting, and cramps.
Venous phlebitis can be a consequence of its parenteral administration
INTERACTIONS: No known interaction with any drugs. But interacts with an antibiotic called Quinuprisitin/ dalfopristin
Nursing considerations: Any medications or solutions ordered must be given exactly as prescribed and w/o substitution.
Route: IV, oral
Calcium
USES: Used for the treatment or prevention of calcium depletion in patients for whom dietary measures are inadequate. Calcium is
involved in the proper development and maintenance of teeth and skeletal bones
ADVERSE EFFECTS: Hypercalcemia, anorexia, nausea, vomiting and constipation. Taking calcium supplements may increase the risk
for developing kidney stones. When administered IM or SubQ mild to severe local reactions: burning, necrosis and sloughing of tissue
INTERACTIONS: If hypercalcemia is present in patients taking digoxin serious cardiac dysrhythmias can occur
NURSING CONSIDERATIONS: Monitor vitals and EKG, monitor intake and output
ROUTE: orally, IV
Magnesium
USES: Used for the treatment of mg deficiency and as a nutritional supplement in total parenteral nutrition and multivitamin
preparations. It is required for muscle contraction and nerve function, It produces an anticonvulsant effect by inhibiting neuromuscular
transmission in selected convulsive states
ADVERSE EFFECTS: Hypermagnesemia which results in tendon reflex loss, difficult bowel movements, CNS depression, resp. Distress
and heart block and hypothermia
INTERACTIONS: The use of mg with neuromuscular blocking drugs and CNS depressants produces additive effects
NURSING CONSIDERATIONS: Monitor of S&S for toxicity(loss of DTR) resp. Depression, oliguria, SOB
ROUTE: Oral and Injectable form
Phosphorus
USES: Important building block for body structures, responsible for cellular energy transfer. Also known for the development and
maintenance for skeletal bones and teeth. Used for the treatment of deficiency states and as a dietary supplement in many multivitamin
formulations
ADVERSE EFFECTS: The use of phosphorus replacement products these effects include (diarrhea, nausea, vomiting, and other GI
disturbances. Confusion, weakness, and breathing difficulties
INTERACTIONS: Antacids can reduce the oral absorption of phosphorus
NURSING CONSIDERATIONS: monitor renal function
ROUTE: oral and parenteral formulations