ELECTROLYTE REPLACEMENT SOLUTIONS
a. Use. Electrolyte replacement solutions provide both electrolytes (like sodium,
potassium, and so forth) and fluid to the patient. Special electrolyte replacement
solutions can be prepared in order to meet the needs of particular patients.
b. Examples of Electrolyte Replacement Solutions. Below are two of the
solutions commonly used to replace electrolytes.
(1) Lactated Ringer's solution (LR, Ringer's lactate, RL, Hartmann's
solution). This product is a solution of electrolytes in water. This product contains
sodium, potassium, calcium, chloride, and lactate ions. The lactate ion in the product
has an alkalizing effect. The lactate ion is metabolized in the liver to glycogen and ends
up as carbon dioxide and water. Lactated Ringer's solution is used as a fluid
replacement and as an electrolyte replacement. Lactated Ringer's is the preferred
solution for heat injuries.
(2) Lactated Ringer's solution with five percent dextrose. This product is a
combination of lactated Ringer's solution and five percent dextrose (D5RL) solution.
The dextrose supplies 170 calories per 1,000 milliliters of solution. Lactated Ringer's
solution with five percent dextrose is used as a fluid replacement, electrolyte
replacement, and as a source of energy.
Other combination products are available.
NUTRIENT SOLUTIONS (HYPERALIMENTATION PRODUCTS)
These products provide total parenteral nutrition for those patients who cannot,
should not, or will not ingest the nutrients they need to live. It should be noted that a
hyperalimentation solution can supply all the patient's nutritional needs by
administration through the circulatory system. However, these solutions are quite
expensive and, because of their nutrient content, are highly susceptible to bacterial
growth. Most of the solutions contain high concentrations of carbohydrates (for
example, dextrose). Because of this high concentration, the solutions must be
administered through a large-bore vein. Just placing the needle or catheter into such a
large-bore vein is a surgical procedure in itself. The hyperalimentation solution is
prepared in the Pharmacy Sterile Products Section by a specially trained person. You
must be very careful to prevent bacterial contamination. The preparation of the product
itself is quite a job because the preparer must add ingredients in a certain sequence.
Many of the components of a hyperalimentation solution are incompatible in certain
concentrations. The components of most hyperalimentation solutions are water,
dextrose, amino acids, electrolytes, and vitamins. One product, IntralipidR, is an oil in
water emulsion. IntralipidR is one hyperalimentation product that can be administered
through a small-bore vein such as those found in the arm.