McKenna's Pharmacology for Nursing, 2e

947

A P P E N D I X B Parenteral agents

■■ TABLE B Parenterals (continued) Commonly used combination fluids a

Na content (mEq/L)

K content (mEq/L)

Cl content (mEq/L)

Ca content (mEq/L)

Mg content (mEq/L)

Lactate (mEq/L)

Acetate (mEq/L)

Osmolarity (mOsm/L)

Solution

Plasma-lyte-56 Ringer’s injection Lactated ringer’s

40

13

 40 156 109  96

—

3

— —

18

111

147 130 140

4 4 5

4 3

—

— 310 — 273

— 28

Normosol-R

—

3

—

27

295

Typical central parenteral nutrition solution a,b Component Purpose 10% Amino acids Provides 50 g protein for growth and healing

Availability

Special considerations

500 mL

Monitor blood pressure, cardiac output, blood chemistries and urine to determine the effect of intravascular protein pull Monitor blood sugar; evaluate injection site for any sign of infection, irritation Monitor for any sign of emboli (e.g. shortness of breath, chest pain, deep leg pain, neurological changes); carefully monitor individual for any sign of increased vascular workload, especially very young and geriatric individuals Monitor for any sign of emboli (e.g. shortness of breath, chest pain, deep leg pain, neurological changes); carefully monitor individuals for any sign of increased vascular workload, especially very young and geriatric individuals Monitor for any sign of emboli (e.g. shortness of breath, chest pain, deep leg pain, neurological changes); carefully monitor individuals for any sign of increased vascular workload, especially very young and geriatric individuals Monitor cardiac rhythm, serum electrolytes

50% Dextrose

Provides 3400 kilojoules for energy Provides 4600 kilojoules ready energy per 1000 mL

500 mL

10% Fat

500 mL

emulsion (Intralipid)

20% Fat

Provides 8400 kilojoules ready energy per 1000 mL

100 mL, 500 mL, 1 L

emulsion (Intralipid)

30% Fat

Provides 12,600 kilojoules, ready energy per 1000 mL

250 mL, 333 mL, 500 mL, 1 L

emulsion (Intralipid)

Sodium chloride Provides sodium and chloride needed for various chemical

40 mEq

reactions within the body Provides essential calcium for muscle contraction, blood clotting, numerous chemical reactions Provides magnesium for various chemical reactions within the body Provides needed potassium for nerve functioning, muscle contractions, etc. Provide a combination of essential vitamins to maintain cell integrity, promote healing Provide small amounts of elements essential for numerous chemical reactions in the body and maintenance of cell integrity and healing

Calcium

4.8 mEq

Monitor cardiac rhythm, muscle strength, serum electrolytes

gluconate

Magnesium sulphate

8 mEq

Monitor blood pressure, deep tendon reflexes and serum electrolytes Monitor pulse, including rhythm, muscle function and serum electrolytes

Potassium

9 mmol

phosphate

Multivitamins

10 mL

Monitor for signs of vitamin deficiency or toxicity

Trace elements

Periodically monitor blood chemistries to determine adequacy of replacement

Zinc

3 mg

Copper

1.2 mg 0.3 mg 12 mcg 20 mcg

Manganese Chromium

Selenium

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