SODIUM BICARBONATE

BRAND NAME
Sodium Bicarbonate 5% injection
DOSAGE
10 ml
FREQUENCY
Q8h
INDICATION
 Severe renal disease
 Uncontrolled diabetes
 Severe primary lactic acidosis
 Circulatory insufficiency due to shock
 Severe dehydration
CONTRAINDICATIONS
 Prolonged therapy with sodium bicarbonate
 Patients losing chloride (as from vomiting, GI suction, diuresis)
 Heart disease
 Hypertension
 Renal insufficiency
 Peptic ulcer
 Pregnancy
SIDE EFFECTS
 Swelling
 High blood sodium levels
 Low blood calcium levels
 Muscle spasms
 Low blood potassium levels
 Dizziness
 Vomiting
ADVERSE EFFECT
GI: Belching, gastric distention, flatulence.
Metabolic: Metabolic alkalosis, electrolyte imbalance, hypocalcemia
Skin: Severe tissue damage following extravasation of IV solution.
Urogenital: Renal calculi or crystals, impaired kidney function
SPECIAL PRECAUTION:
 Patient with CHF
 Hypertension cirrhosis, eclampsia, oedema, aldosteronism, oliguria or anuria. Avoid
extravasation (IV).
 Renal and hepatic impairment.
 Children.
 Pregnancy and lactation.
NURSING CONSIDERATION:
 Assess the client’s fluid balance throughout the therapy. This assessment includes intake
and output, daily weight, edema, and lung sounds.
 Patients with diminished renal function, administration of solutions containing sodium
ions are not advised to take the drug as it may result in sodium retention.

SODIUM CHLORIDE
BRAND NAME
Swabflush, Syrex
DOSAGE
1,000 mL IV bolus at a maximum infusion rate (over 5 to 10 minutes)
FREQUENCY
N/A
INDICATION
It is used to clean out an intravenous (IV) catheter, which helps prevent blockage and removes
any medicine left in the catheter area after you have received an IV infusion.
CONTRAINDICATIONS
 Hypertonic uterus
 Hypernatremia
 Fluid Retention
 Hemolysis
 Children
SPECIAL PRECAUTION:
 Assess fluid and sodium status and adjust therapy as appropriate.
 Maintaining appropriate sodium balance can be very challenging for some neonates.
  Many physiological changes occur during the first weeks of life that affect the neonate's
handling of fluid and sodium, especially in premature neonates.
 Fluid resuscitation in neonates, particularly premature neonates, may cause rapid volume
expansion and has been associated with intraventricular hemorrhage.
SIDE EFFECTS
 Febrile response
 Infection at the site of injection
ADVERSE EFFECT
 Venous thrombosis or phlebitis extending from the site of injection
 Hypervolemia
 Hemolysis
 Erythema

NURSING CONSIDERATION:
 Monitor IV site for redness, swelling or tenderness
 BP and HR, baseline, then every 30 minutes during infusion until stable
 Must be given with infusion pump.
 Central infusion is preferred because 3% sodium chloride is very hypertonic
 If peripheral infusion is necessary, a large vein with good blood flow is preferred
 Take care to avoid extravasation

CALCIUM GLUCONATE
BRAND NAME
Gluconate
DOSAGE
0.5 mL
FREQUENCY
1 min
INDICATION
Calcium gluconate is used to treat conditions arising from calcium deficiencies such as
hypocalcemic tetany, hypocalcemia related to hypoparathyroidism and hypocalcemia due to
rapid growth or pregnancy.
CONTRAINDICATIONS
 Patients with hypercalcemia
  Hypercalciuria
 Severe renal failure
 IV: Concomitant use with ceftriaxone in premature

SPECIAL PRECAUTIONS
 Patients with cardiac impairment, nephrocalcinosis, sarcoidosis, severe hypokalemia,
hypomagnesemia, Ca renal calculi or history of renal calculi, calculi formation in the
urinary tract, severe hyperphosphatemia.
 Renal impairment.
 Children. Pregnancy and lactation.
 Patients receiving cardiac glycosides.
SIDE EFFECTS
 Warmth, tingling, or a heavy feeling.
 A chalky taste in mouth
 Upset stomach
 Constipation
ADVERSE REACTIONS
Gastrointestinal disorders: Gastrointestinal irritation, nausea, vomiting, chalky taste
Musculoskeletal and connective tissue disorders: Tingling sensation
Nervous system disorders: Anxiety
Vascular disorders: Hypotension, flushing, syncope
Potentially Fatal: Circulatory collapse

NURSING CONSIDERATION:
 Store at room temperature, and protect from heat, moisture, and direct light.
 Don’t freeze.
 Assess for cutaneous burning sensations and peripheral vasodilation, with moderate fall
in BP, during direct IV injection.
 Monitor ECG during IV administration to detect evidence of hypercalcemia: decreased
QT interval associated with inverted T wave.
 Monitor for hypocalcemia and hypercalcemia
 Check regularly for infiltration because calcium causes necrosis.