IV Fluids & Drip Rates
IV Fluid Types
| Fluid | Tonicity | Na+ (mEq/L) | Uses |
|---|---|---|---|
| NS (0.9%) | Isotonic | 154 | Fluid resuscitation, blood transfusions, maintenance |
| 1/2 NS (0.45%) | Hypotonic | 77 | Free water replacement, hypernatremia |
| D5W | Isotonic (becomes hypotonic) | 0 | Free water, dextrose source; caution in hyponatremia |
| D5 1/2 NS | Hypertonic | 77 | Maintenance, post-op |
| D5NS | Hypertonic | 154 | Hypovolemia with dextrose |
| LR (Lactated Ringer's) | Isotonic | 130 | Fluid resuscitation, surgery; contains K+, Ca²⁺, lactate |
| D10W | Hypertonic | 0 | Neonatal/pediatric dextrose, hypoglycemia |
Drip Rate Formula
gtt/min = (Volume mL × Drop Factor) / (Time in minutes)
IV Pump Rate
mL/hr = Volume / Time (hours)
Example: 1000 mL over 8 hours = 1000 ÷ 8 = 125 mL/hr.
Common Drop Factors
| Tubing Type | Drop Factor |
|---|---|
| Macrodrip (standard) | 10 gtt/mL |
| Macrodrip (blood) | 15 gtt/mL |
| Macrodrip | 20 gtt/mL |
| Microdrip (pediatric) | 60 gtt/mL |
IV Complications
| Complication | Signs/Symptoms | Nursing Action |
|---|---|---|
| Infiltration | Swelling, coolness, pallor at site; slowed/stopped flow | Stop infusion, remove IV, elevate limb, warm/cool compress per protocol |
| Extravasation | Same as infiltration but with vesicant (chemotherapy, etc.); tissue damage risk | Stop immediately, aspirate if possible, antidote per drug, document |
| Phlebitis | Redness, warmth, tenderness, streak along vein | Discontinue IV, apply warm compress, document |
| Air Embolism | Sudden dyspnea, chest pain, hypotension, altered mental status | Clamp tubing, position left lateral Trendelenburg, notify provider, O₂ |
| Speed Shock | Rapid onset of flushing, headache, hypotension, syncope | Slow or stop infusion, assess VS, notify provider |