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NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You (You will need to make additional copies of these forms) Generic Name sodium chloride, sodium lactate, potassium chloride, and calcium chloride Peak Unknown (several sources checked)
Trade Name Lactated Ringers
Classification Fluid/electrolyte replacement, blood volume expander
Onset Duration Unknown Unknown (several (several sources sources checked) checked) Why is your patient getting this medication Extracellular fluid/ electrolyte replacement
Dose 1000 mL
Route IV
Time/freq Q 24 hrs @
Normal dosage range The dose is dependent upon the age, weight an condition of the patient as well as laboratory determinations.
For IV meds, compatibility with IV drips an solutions There are many drugs that are incompatible w commonly used emergency medications that a incompatible are nitroglycerin, nitroprusside, norepinephrine, mannitol, procainamide, prop methylprednisolone.
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Mechanism of action and indications Nursing Implications (what to focus on) (Why med ordered) Contraindications/warnings/interactions Isotonic Solution. When administered administered No known contraindications. Use precaution intravenously, intravenously, these solutions provide sources of renal insufficiency, insufficiency, edema states with sodium water and electrolytes. Their electrolyte content Hyperkalemia, metabolic or respiratory alkalo resembles that of the principal ionic constituents of administer simultaneously with blood through normal plasma and the solutions therefore are administration set because of the likelihood of suitable for parenteral replacement of extracellular losses of fluid and electrolytes. electrolytes. Calcium chloride in Common side effects water dissociates to provide calcium (Ca++) and Fever, infection at administration site, venous chloride (Cl−) ions. They are normal constituents of extravasation, hypervolemia. the body fluids and are dependent on various physiologic mechanisms for maintenance of balance between intake and output. Approximately 80% of body calcium is excreted in the feces as insoluble salts; urinary excretion accounts for the remaining 20%. Potassium chloride in water dissociates dissociates to provide potassium (K+) and chloride (Cl−) ions. Potassium is found in low concentration in plasma and extracellular fluids (3.5 to 5.0 mEq/liter in a healthy adult). It is the chief cation of body b ody cells (160 mEq/liter of intracellular water). Potassium plays an important role in electrolyte balance. Normally about 80 to 90% of the potassium intake is excreted in the urine urine;; the remainder in the stools and to a small extent, in the perspiration. The kidney does not conserve potassium well so that during d uring fasting or in patients on a potassium-free diet, potassium loss from the body continues resulting in potassium depletion. depletion. Sodium chloride in water dissociates to provide sodium (Na+) and chloride Sign up to vote on this title (Cl−) ions. Sodium (Na+) is the principal cation of Useful Not useful the extracellular fluid and plays a large part in the therapy of fluid and electrolyte disturbances. Chloride (Cl−) has an integral role in buffering
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Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) None for this patient
Nursing Process- Assessment (Pre-administration assessment) Assess level of hydration
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Lab value alterations caused by medicine Serum electrolytes ↑
Be sure to teach the patient the following ab medication Report any adverse effects, edema, difficulty b angina to provider. provider. Assessment Evaluation Why would you hold or not give this Check after giv med? Hydration/elect Occurrence of an adverse reaction. Overdose (overhydration, solute overload).
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