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IV FLUIDS AND USES / SPECIAL CONSIDERATIONS

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Question
Answer
D5W - USES   ISOTONIC - FLUID LOSS AND DEHYDRATION, HYPERNATREMIA  
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0.9% SODIUM CHLORIDE - USES   NORMAL SALINE - SHOCK, HYPONATREMIA, BLOOD TRANSFUSIONS, RESUSCITATION, FLUID CHALLENGES, METABOLIC ALKALOSIS, HYPERCALCEMIA, FLUID REPLACEMENT IN DKA  
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LACTATED RINGERS - USES   DEHYDRATION, BURNS, LOWER GI TRACT FLUID LOSS, ACUTE BLOOD LOSS, HYPOVOLEMIA DUE TO THIRD SPACING  
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0.45% SODIUM CHLORIDE - USES   HYPOTONIC - WATER REPLACEMENT, DKA AFTER INITIAL NORMAL SALINE SOLUTION AND BEFORE DEXTROSE INFUSION, HYPERTONIC DEHYDRATION, SODIUM AND CHLORIDE DEPLETION, GASTRIC FLUID LOSS FROM NG SUCTIONING OR VOMITING  
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D5 1/2NS - USES   HYPERTONIC - DKA AFTER INITIAL TREATMENT WITH NORMAL SALINE SOLUTION AND HALF-NORMAL SALINE SOLUTION - PREVETS HYPOGLYCEMIA AND CEREBRAL EDEMA (OCCURS WHEN SERUM OSMOLALITY IS REDUCED TOO RAPIDLY)  
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D5 NS - USES   HYPOTONIC DEHYDRATION, TEMPORARY TREATMENT OF CIRCULATORY INSUFFICIENCY AND SHOCK IF PLASMA EXPANDERS NOT AVAILABLE. SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE (OR USE 3% SODIUM CHLORIDE), ADDISONIAN CRISIS  
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D10W - USES   WATER REPLACEMENT, CONDITIONS IN WHICH SOME NUTRITION WITH GLUCOSE IS REQUIRED  
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D5W - CONSIDERATIONS   * SOLUTION IS ISOTONIC INITIALLY; BECOMES HYPOTONIC WHEN DEXTROSE IS METABOLIZED* DONT USE FOR RESUSCITATION; CAN CAUSE HYPERGLYCEMIA* USE CAUTIOUSLY IN RENAL AND CARDIAC DISEASE; CAN CAUSE FLUID OVERLOAD* LONG TERM; MAY CAUSE BREAKDOWN OF PROTEIN  
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0.9% SODIUM CHLORIDE (NS) - CONSIDERATIONS   * SINCE THIS REPLACES EXTRACELLULAR FLUID, DONT USE IN PATIENTS WITH CHF, EDEMA, OR HYPERNATREMIA, CAN LEAD TO OVERLOAD  
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LACTATED RINGERS - CONSIDERATIONS   * ELECTROLYTE CONTENT IS SIMILAR TO SERUM BUT DOESNT CONTAIN MAGNESIUM* CONTAINS K+; DONT USE WITH RENAL FAILURE; CAN CAUSE HYPERKALEMIA* DONT USE IN LIVER DISEASE; THE PT CANT METABOLIZE LACTATE; GOOD LIVER CONVERTS TO BICARB; DONT GIVE IF PH>7.5  
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0.45% SODIUM CHLORIDE (1/2NS) - CONSIDERATIONS   * USE CAUTIOUSLY; MAY CAUSE CARDIOVASCULAR COLLAPSE OR INCREASED INTRACRANIAL PRESSURE* DONT USE IN PATIENTS WITH LIVER DISEASE, TRAUMA, OR BURNS  
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D5NS - CONSIDERATIONS   * DONT USE IN CARDIAC OR RENAL PATIENTS BECAUSE OF DANGER OF CHF AND PULMONARY EDEMA  
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D10W - CONSIDERATIONS   * MONITOR SERUM GLUCOSE LEVELS  
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