Nurses Compass
Drug Guide
Calcium Chloride, Dextrose, Magnesium Chloride, Potassium Chloride, Sodium Acetate, Sodium Chloride, Sodium Lactate (Plasma-Lyte M and Dextrose 5%)
Classification
Therapeutic: Electrolyte and fluid replacement solution
Pharmacological: Intravenous electrolyte and fluid therapy
FDA Approved Indications
- Electrolyte replenishment
- Fluid replacement in dehydration
- Correction of metabolic acidosis
Mechanism of Action
Provides essential electrolytes and buffers to restore fluid and electrolyte balance and maintain blood pH.
Dosage and Administration
Adult: Dosage varies based on clinical condition; administer via infusion, titrated based on electrolyte levels and fluid status.
Pediatric: Dose determined based on body weight and clinical condition, under medical supervision.
Geriatric: Same as adult, with attention to renal function and electrolyte levels.
Renal Impairment: Adjust dosages based on severity of renal impairment; monitor electrolytes closely.
Hepatic Impairment: Use with caution; monitor for acid-base and electrolyte disturbances.
Pharmacokinetics
Absorption: N/A (intravenous administration)
Distribution: Electrolytes distribute throughout body compartments; plasma concentrations reflect extracellular fluid levels.
Metabolism: Electrolytes are not metabolized but used in cellular and metabolic functions.
Excretion: Electrolytes are eliminated via renal and gastrointestinal routes.
Half Life: Varies depending on electrolyte and fluid status; primarily renal clearance.
Contraindications
- Hyperkalemia
- Hypernatremia
- Hypercalcemia
- Severe renal impairment
- Acidosis
Precautions
- Monitor serum electrolyte levels regularly during therapy
- Use with caution in cardiac disease, kidney dysfunction, or edema
- Avoid rapid infusion to prevent cardiovascular or metabolic complications
Adverse Reactions - Common
- Hypokalemia (rare)
- Hyperkalemia (rare)
- Fluid overload or edema (rare)
- Hypernatremia (rare)
- Local irritation at infusion site (rare)
Adverse Reactions - Serious
- Cardiac arrhythmias (rare)
- Metabolic acidosis/alkalosis depending on electrolyte imbalance (rare)
Drug-Drug Interactions
- Potassium-sparing diuretics, ACE inhibitors (risk of hyperkalemia)
- Digoxin (risk of toxicity with electrolyte imbalance)
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor serum electrolytes, renal function, hydration status, and cardiac rhythm.
Diagnoses:
- Risk for electrolyte imbalance
- Fluid volume excess
Implementation: Administer IV solutions per ordered rate, monitor infusion site, observe for adverse effects.
Evaluation: Assess for resolution of electrolyte imbalances, hydration status, and absence of adverse reactions.
Patient/Family Teaching
- Report any swelling, chest pain, irregular heartbeat, or changes in mental status.
- Avoid other sources of excess electrolytes without healthcare provider guidance.
Special Considerations
Black Box Warnings: N/A
Genetic Factors: Genetic conditions affecting electrolyte handling are not specifically impacted by these solutions.
Lab Test Interference: Electrolyte solutions can affect serum electrolyte measurements; draw labs before infusion if possible.
Overdose Management
Signs/Symptoms: Hyperkalemia, hypernatremia, fluid overload, cardiac arrhythmias.
Treatment: Discontinue infusion, correct electrolytes with specific antidotes if needed, provide supportive care, consider dialysis in severe cases.
Storage and Handling
Storage: Store at controlled room temperature, away from light and moisture.
Stability: Stable until expiration if stored properly; consult manufacturer guidelines.