in hypovolemic shock. Normal saline solution is also used to irrigate wounds, because
it is not irritating to tissue.
b. Administration. Sodium chloride injection is given parenterally. About 2000
ml, or more, of sodium chloride per day by intravenous infusion is required to keep the
client's urine output at a desired amount of 1200 to 1500 ml of urine for each 24-hour
period.
c. Untoward Effects. The intravenous infusion of sodium chloride can lead to
edema, acidosis, and loss of potassium--especially when therapy is continued over a
prolonged period.
d. Cautions and Contraindications. This preparation should be kept from
freezing. It should not be used for intravenous infusion if it is discolored, or it contains
sediment, or if no vacuum is detected when the intravenous assembly is attached.
e. How Supplied. Sodium chloride injection is supplied in 5-ml-ampules, in an
infusion bag containing 250-ml for pediatric parenteral use, and in infusion bags
containing 1000 ml for parenteral use. It is also supplied in 150-ml, 250-ml, 500-ml,
and 1000-ml. transparent, flexible plastic, single-dose containers. Sodium chloride
injection, modified, is supplied in 1000-ml flexible plastic containers with graduation
intervals at each 100-ml, including an infusion set, swab-type antiseptic ampule, and a
carton that converts into an armboard.
4-20. RINGER'S INJECTION
a. Action and Uses. Ringer's injection is an isotonic solution which supplies
the three important cations: sodium, potassium, and calcium. It has a slightly greater
therapeutic value as a fluid and electrolyte replenisher than sodium chloride injection.
However, large volumes of Ringer's injection, like sodium chloride injection, alter the
acid-base balance.
b. Administration. The usual dose by intravenous infusion is 1000-ml.
c. How Supplied. Ringer's injection is supplied in 500-ml and 1000-ml
transparent, flexible plastic, single-dose containers.
4-21. LACTATED RINGER'S INJECTION
a. Action and Uses. Lactated Ringer's injection is used as a fluid and
electrolyte replenisher. Designed to avoid the tendency of sodium chloride injection to
cause acidosis, it also supplies the important cations: sodium, potassium, and calcium.
Sodium lactate is included because lactate eventually metabolizes to bicarbonate and
thus alkalinizes the body fluids. However, bicarbonate itself is not included because it
tends to hasten the calcium ions as calcium carbonate in heated solutions.
b. Administration. The usual dose by intravenous infusion is 1000-ml.
MD0913
4-15