This chapter highlights several considerations in the use of intravenous fluids in the geriatric patient, specifically sodium and water. It emphasizes that these key elements of routine intravenous fluid orders are also body nutrients, required in limits to avoid the adverse consequences of either excess or deficit. A review of basic sodium and water distribution, regulation, and excretion is provided. The sodium content of various salt-containing fluids and supplements are presented as well as general principles underlying sodium administration. The goal of intravenous fluid (IV) administration is to carefully achieve and maintain a euvolemic and isotonic environment within the body as well as to provide for a variety of nutritional and pharmacologic interventions. The selection of an appropriate IV solution is dependent upon the fluid volume and electrolyte status of the individual patient as well as any additional specific therapeutic goals.
Intravenous fluids Normal saline Sodium and water administration Dehydration Insensible losses Gastrointestinal losses Renal losses Sodium content of fluids Euvolemia Hypovolemia Isotonic fluids Hypotonic fluids Intravenous volume replacement Hyponatremia Hypernatremia
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