NURS 1566 Clinical Form 3: Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency

sodium chloride, Lactated Ringers Fluid/electrolyte 1000 mL IV Q 24 hrs @ 42 mL/hr
sodium lactate, replacement, blood
potassium volume expander
chloride, and
calcium chloride
Peak Onset Duration Normal dosage range
Unknown Unknown Unknown The dose is dependent upon the age, weight and clinical
(several sources (several (several sources condition of the patient as well as laboratory
checked) sources checked) determinations.
checked)
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or
Extracellular fluid/ electrolyte replacement solutions
There are many drugs that are incompatible with LR, some
commonly used emergency medications that are
incompatible are nitroglycerin, nitroprusside,
norepinephrine, mannitol, procainamide, propranolol,
methylprednisolone.
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Isotonic Solution. When administered No known contraindications. Use precaution with CHF,
intravenously, these solutions provide sources of renal insufficiency, edema states with sodium retention,
water and electrolytes. Their electrolyte content Hyperkalemia, metabolic or respiratory alkalosis, DO NOT
resembles that of the principal ionic constituents of administer simultaneously with blood through same
normal plasma and the solutions therefore are administration set because of the likelihood of coagulation.
suitable for parenteral replacement of extracellular
losses of fluid and electrolytes. Calcium chloride in Common side effects
water dissociates to provide calcium (Ca++) and Fever, infection at administration site, venous thrombosis,
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 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 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; the remainder in the stools and
to a small extent, in the perspiration. The kidney
does not conserve potassium well so that during
fasting or in patients on a potassium-free diet,
potassium loss from the body continues resulting in
potassium depletion. Sodium chloride in water
dissociates to provide sodium (Na+) and chloride
(Cl−) ions. Sodium (Na+) is the principal cation of
the extracellular fluid and plays a large part in the
therapy of fluid and electrolyte disturbances.
Chloride (Cl−) has an integral role in buffering
action when oxygen and carbon dioxide exchange
occurs in the red blood cells. The distribution and
excretion of sodium (Na+) and chloride (Cl−) are
largely under the control of the kidney which
maintains a balance between intake and output.
Sodium lactate provides sodium (Na+) and lactate
(C3H5O3−) ions. The lactate anion is in equilibrium
with pyruvate and has an alkalizing effect resulting
from simultaneous removal by the liver of lactate
and hydrogen ions. In the liver, lactate is
metabolized to glycogen which is ultimately
converted to carbon dioxide and water by oxidative
Interactions with other patient drugs, OTC or Lab value alterations caused by medicine
herbal medicines (ask patient specifically) Serum electrolytes ↑
None for this patient
Be sure to teach the patient the following about this
medication
Report any adverse effects, edema, difficulty breathing,
angina to provider.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
Assess level of hydration med? Hydration/electrolyte status
Occurrence of an adverse reaction.
Overdose (overhydration, solute
overload).