Question

What coexisting illness might have an impact on the selection and rate of IV fluid therapy?

Answer 1

Ans) Patients receiving IV fluid therapy to address replacement or redistribution problems may need more frequent monitoring additional monitoring of urine sodium can help to identify whole-body sodium depletion in patients who have high-volume gastrointestinal losses, and may be useful in assessing sodium status.

- Deciding on the optimal amount, composition and rate of administration of IV fluids to address these often complex needs is inherently difficult yet assessment, prescribing and monitoring of IV fluids in general admission and ward areas of hospitals, is often left to junior doctors and hard-pressed nurses who may lack required training and competence. Evidence suggests that mismanagement of fluids is common, particularly in general ward areas with the potential for adverse outcomes including excess morbidity and mortality, prolonged hospital stays and increased costs.

- There is, therefore, a clear need for guidance on IV fluid prescribing applicable to general ward areas but since most randomized controlled trials of IV fluid therapy have examined narrow clinical questions in intensive care or intra-operative settings, many recommendations for more general use must be based on first principles. All health professionals involved in prescribing and administering IV fluids need to understand these principles if they are to prescribe and manage IV fluid therapy safely and effectively.