McKenna's Pharmacology for Nursing, 2e

946

A P P E N D I X B  Parenteral agents

Evaluation

nutrition for the person ; taper slowly to avoid severe reactions. ■ ■ Provide comfort measures to help the person tolerate drug effects (e.g. provide skin care as needed, analgesics, hot soaks to extravasation sites). ■ ■ Include information about the solution being used in a test (e.g. what to expect, adverse effects that may occur, follow-up tests that may be needed) to enhance knowledge about drug therapy and promote compliance with the drug regimen.

■ ■ Monitor response to the drug (stabilisation of nutritional state, fluid and electrolyte balance, laboratory values). ■ ■ Monitor for adverse effects (local irritation, infection, fluid and electrolyte imbalance). ■ ■ Evaluate the effectiveness of the teaching plan (person can name adverse effects to watch for and specific measures to avoid them; person understands the importance of follow-up that will be needed). ■ ■ Monitor the effectiveness of comfort measures and compliance with the regimen.

■■ TABLE B Parenterals

Kilojoule content (kl/L)

Osmolarity (mOsm/L)

Solution

Usual indications

In solutions

Dextrose solutions

5% (50 g/L)

835

278

Provides kilojoules and fluid, keeps vein open for administration of IV drugs; frequent choice for dilution of IV drugs Hypertonic solution used after admixture with other fluids; provides kilojoules and fluid Hypertonic solution used after admixture with other fluids; provides kilojoules and fluid; treatment of acute hypoglycaemic episodes in infants to restore glucose levels and suppress symptoms; sclerosing agent for varicose veins Hypertonic solution used after admixture with other fluids; provide kilojoules and fluid; treatment of hyperinsulinaemia; sclerosing agent for varicose veins Hypertonic solution used after admixture with other fluids; provides kilojoules and fluid

10% (100 g/L)

1670

556

25% (250 g/L)

4175

1389

50% (500 g/L)

8350

2778

70% (700 g/L)

11690

3889

Sodium content (mEq/L)

Chloride content (mEq/L)

Osmolarity (mOsm/L)

Solution

Usual indications

Saline solutions

0.45% (½ normal saline)

77

77

155

Hydrating solution; may be used to evaluate kidney function; treatment of hyperosmolar diabetes Replacement of fluid, sodium and chloride; flushing lines and catheters; dilution of IV medications; priming of dialysis machines; neonatal blood transfusions Hypertonic solution to treat sodium and chloride depletion; emergency treatment of water intoxication or severe salt depletion Hypertonic solution to treat sodium and chloride depletion; emergency treatment of water intoxication or severe salt depletion

0.9% (normal)

154

154

310

3%

513

513

1030

5%

855

855

1710