effective, but other fluids should be given until completion of the necessary laboratory
work and acquisition of the correct type of blood. A frequent course in hypovolemic
shock is to immediately administer 500-2000 ml of sodium chloride injection
(physiologic saline), Ringer's injection, lactated Ringer's injection, or five percent
dextrose in saline rapidly intravenously, while making preparations of plasma protein
fraction, serum albumin, or whole blood.
c. General Precautions for Intravenous Solutions.
Do not overload the client with fluids.
Check expiration date of solution.
Do not administer a solution which is discolored or contains sediment.
Do not administer if leakage from the bag is detected.
Check urine output per hour.
4-16. NORMAL HUMAN SERUM ALBUMIN
a. Action and Uses. The albumin content in normal human serum albumin is a
large-molecule protein extracted from human blood. It is an effective but potentially
harmful blood volume substitute in emergencies; it is useful when the client has lung
injury, because it acts by drawing fluid into the blood vessels from the surrounding
tissues. This preparation is used also in other clinical situations where protein
replacement therapy is indicated--such as nephrosis, certain skin diseases, and others.
One vial of 25 percent albumin (100 ml) is equivalent to 500 ml of plasma.
b. Administration. Albumin is administered by intravenous infusion. The usual
dose is 100 ml of 25 percent solution or 500 ml of a five-percent solution.
c. Untoward Effects. There are no untoward reactions to the administration of
albumin in therapeutic amounts. However, unless this drug is given concurrently with
infusions of saline or dextrose solutions, it will worsen the condition of a dehydrated
client by drawing additional fluid from his tissues.
d. Cautions and Contraindications. This preparation should be refrigerated,
however, it is damaged by freezing. The 25 percent solution has a potency period of
120 months when the drug is refrigerated, but its life is only half this long if it is not
refrigerated. It should not be used if no vacuum is detected when the intravenous
hookup is inserted into the bottle. As noted above, the preparation should be
administered simultaneously with solutions of saline and dextrose when used in the
treatment of dehydrated clients.