This lesson discusses the details about hydrating agents that can be given intravenously and the administration of electrolytes. We’ll take a look at the importance of water and electrolyte balance as well.
It has been well documented that our bodies are made mostly of water. In fact, we are made up of between 70% – 80% water. This is not by coincidence. We are composed of that much water because water is needed for every process that takes place in our bodies.
Water isn’t the only key player in most processes in our bodies. Equally important are the electrolytes in our bodies. You have heard that word before. Electrolytes are the chemical ions necessary for body processes. The main electrolytes needed in the body are sodium, abbreviated as Na+, and potassium, abbreviated as K+. Other pertinent electrolytes include magnesium, phosphate, and chloride.
Both water and electrolytes are so important to the body that they must be maintained at certain levels, and they must be in balance with each other in order to carry out bodily functions. This balance between the amount of water and electrolytes in the body is called the water/electrolyte balance. The balance is usually maintained by the kidneys.
There are times that there is not enough water to allow the kidneys to do their job. When a person has lower than normal water levels in the body, we call this dehydration. Dehydration can cause many problems in the body largely due to the fact that the body starts to shut down without enough water. Having lower than normal water levels also throws off the body’s water/electrolyte balance. That can be very dangerous and deadly if not corrected quickly and correctly. That is where you and other healthcare professionals come to the rescue.
Now there are times when a person can just simply drink water or consume other fluids to correct mild cases of dehydration. This is even sometimes done in the hospital if the case is very mild, and other problems have not started as a result of dehydration. When it is a more serious case, or problems are happening in the body as a result of dehydration, then nurses or other healthcare professionals administer hydrating agents that contain water and electrolytes to restore the normal water/electrolyte balance through an intravenous line.
One hydrating agent is lactated ringers, abbreviated as LR, which is a solution of sodium chloride, potassium chloride, sodium lactate, and calcium chloride. Lactated ringers are the preferred hydrating agent when a patient is dehydrated and has a mild case of acidosis. Because of the amount of potassium in the solution, it will rarely, if ever, be used for patients that have high blood potassium or conditions that could lead to high blood potassium. It is also not given to patients that are experiencing alkalosis.
Sometimes patients are dehydrated due to not eating or drinking. This not only throws off the water/electrolyte balance, but it also causes a drop in blood sugar levels. These patients will most likely receive 5% dextrose and water, also called D5W, which is a solution of 5% dextrose in water. Dextrose is a sugar that can be broken down into glucose, the sugar that is needed in the body. This will help with hydrating the patient and raising the blood sugar level. 5% dextrose is not normally given to patients that have diabetes, kidney disease, or liver disease.
Normal saline is the hydrating agent used most often. It is a solution of water and 9.5g/L of sodium chloride. Patients that aren’t able to receive the previous two agents are normally able to receive normal saline. There are some patients that need to be monitored more closely if they receive normal saline. These include patients with edema, congestive heart failure, and reduced kidney function. Normal saline can help to fully restore the water/electrolyte balance.
The reason why normal saline cannot be used for the conditions I just mentioned is mostly because of the amount of sodium contained in the solution. There is a better option for those patients, called half normal saline. This solution of 4.5 g/L of sodium chloride has less electrolytes in it than normal saline. It can help with patients that are dehydrated but still have close to normal electrolyte levels.
The last hydrating agent that is commonly used is dextrose in saline, also called D5 one half normal saline. You probably realize based on the name that it contains both sodium and dextrose. Dextrose in saline is a solution of 2.5% dextrose and 4.5 g/L of sodium chloride. This is a better option for patients that have some of the conditions that prevent administration of the other hydrating agents.
Similar to how there are some patients that may need just water, there are some patients that may need just electrolytes. Electrolytes are usually best replaced by simply eating foods or consuming drinks that contain electrolytes. Common table salt can usually correct a drop in electrolytes. In the event that medical intervention is needed, there are a couple of options available.
Oral electrolytes are electrolytes given in pill or powder form. The powder gets dissolved in water, and then, the patient drinks the solution. The oral electrolytes don’t cause very quick and drastic changes to the electrolyte levels. Oral electrolytes are used in patients that can’t or won’t eat and in those suffering from severe diarrhea and/or vomiting. If the patient is eating, then their diet will be monitored to ensure they don’t consume too much salt or other electrolytes. We don’t want the opposite problem to occur.
The other option is to give IV electrolytes, or electrolytes administered through an IV line. This is most often used if a patient is overhydrated, can’t eat, is a burn victim, or has some severe intestinal diseases. The composition of electrolytes will vary based upon the needs of the individual patient.
We took a look at some options that we as healthcare professionals have to treat patients. Here’s a recap of what we learned today.
Electrolytes are the chemical ions necessary for body processes. The main electrolytes needed in the body are sodium, abbreviated as Na+, and potassium, abbreviated as K+. The balance between the amount of water and electrolytes in the body is called water/electrolyte balance. Lower than normal water levels in the body is called dehydration.
We then covered the hydrating agents frequently used in healthcare. Lactated ringers, abbreviated as LR, is a solution of sodium chloride, potassium chloride, sodium lactate, and calcium chloride. 5% dextrose and water, also called D5W, is a solution of 5% dextrose in water. Normal saline is a solution of water and 9.5g/L of sodium chloride. Half normal saline is a solution of 4.5 g/L of sodium chloride. Dextrose in saline, also called D5 one half normal saline, is a solution of 2.5% dextrose and 4.5 g/L of sodium chloride. Oral electrolytes are electrolytes given in pill or powder form. IV electrolytes are electrolytes administered through an IV line.