Name of Drug Classification Mechanism of Action Indication Contraindication Side Effects Nursing Responsibilities

Generic Name Therapeutic Sodium is a major cation in Patient Indication Contraindication (significant/life- Before
Normal Saline Solution; Classification extracellular fluid and helps Fluid and electrolyte - Fluid retention threatening) > Take baseline vital signs
NSS; Sodium Chloride mineral and maintain water distribution, fluid replacement - Hypernatremia > Accidental administration of
electrolyte and electrolyte balance, acid- - Hypersensitivity and CV: heart hypertonic sodium chloride
Available Trade Names replacements/ base equilibrium, and osmotic General Indication infusion reactions fibrillation, solutions (greater than 0.9%)
Endure Medical 0.9% supplements pressure. - Hydration and pulmonary has resulted in serious
NaCl, Elin, Euro-Med, etc. provision of NaCl in Precaution edema, edema. electrolyte imbalances. Do
Pharmacologic Chloride is the major anion in deficiency states. - Hypertension, not confuse vials of
Patient Dosage Classification extracellular fluid and is involved - Maintenance of - heart failure, F and E: concentrated sodium
1000 mL @ 120cc/hour crystalloid in maintaining acid-base balance. fluid and electrolyte - peripheral or hypernatremia, chloride (23.4%) with vials of
solution, isotonic Solutions of NaCl resemble status in situations pulmonary edema, hypervolemia, sodium chloride flush
Route IV solution (0.9%), extracellular fluid. Reduces in which losses may - impaired renal hypokalemia. solution (0.9%).
Form IV fluid infusion corneal edema by an osmotic be excessive (excess function, > Visually inspect products for
Note: 0.45% is effect diuresis or severe - liver cirrhosis, Local: IV— particulate matter and
Maximum Dosage: hypotonic, 3% nd salt restriction) - preeclampsia extravasation, discoloration prior to
1,000 mL/day, or 20 5% are These fluids remain within the - 0.9% (“normal - patients receiving irritation at administration
mL/kg IV per bolus hypertonic extracellular compartment and saline”) solution is corticosteroids or IV site > Explain to patient the
solutions are distributed between used for: corticotrophin purpose of the infusion
Minimum Dosage: intravascular (blood vessels) and Replacement, During
15 to 20 mL/kg/hr. Pregnancy interstitial (tissue) spaces, Treatment of Pedi: NaCl preserved > Immediately stop the
Dosage, rate, and Category increasing intravascular volume metabolic alkalosis, with benzyl alcohol infusion and institute
duration of C A priming fluid for should not be used in appropriate therapeutic
administration are to be Therapeutic Effects: hemodialysis, To neonates; Inadequate countermeasures if signs or
individualized and Replacement in deficiency states begin and end blood hydration (water and symptoms of
depends on age, weight, and maintenance of homeostasis. transfusions. Small other electrolytes must hypersensitivity occur.
fluid/ electrolyte volumes of 0.9% be replaced). > Assess fluid balance (intake
condition, and on the Pharmacokinetics: NaCl (preservative- and output, daily weight,
patient’s clinical and Absorption: Well absorbed free or edema, lung sounds)
laboratory response to following oral administration. bacteriostatic) are throughout therapy
treatment. Replacement solutions of NaCl used to reconstitute > Assess patient for symptoms
are administered IV only. or dilute other of hyponatremia or
Availability medications hypernatremia throughout
IV solution: 0.9%, 0.45%, Distribution: Rapidly and widely - Irrigating solution therapy
3%, 5%, 23.4% distributed - Additive to > Monitor serum sodium,
Nasal solution: 0.65%, parenteral fluid potassium, bicarbonate, and
3%, 5% Metabolism and Excretion: therapy in very chloride concentrations and
IM and subcu injection Excreted primarily by the kidneys, specific situations acid-base balance
solution: 0.9% with small amounts excreted in periodically for patients
Respi inhalation solution: the sweat, feces, tears and saliva. receiving prolonged therapy
0.9%, 3%, 3.5%, 6%, 7%, with sodium chloride
10% Half-life: unknown > Monitor for irritation at IV

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 Ophthalmic ointment: site. Stop immediately and
5% Route PO notify healthcare provider.
Topical wound wash: Onset unknown Elevate site, provide warm
0.9% Peak unknown compresses, administer non-
Duration unknown steroidal agents as
Chemical Content necessary.
308 mOsm/L; Route IV After
Na+ 154 mmol/L; Onset rapid (min) > Maintain adequate water
Cl- 154 mmol/L; Isotonic Peak end of infusion intake
solutions have a Duration unknown > Monitor fluid balance,
concentration of serum electrolytes and acid-
dissolved particles similar base balance especially
to plasma, and an during prolonged treatment
osmolality of 250 to 375 > Monitor for signs of
mOsm/L. hypervolemia such as
hypertension, bounding
pulse, pulmonary crackles,
dyspnea, shortness of
breath, peripheral edema,
jugular vein distension (JVD)
and extra heart sounds such
as S3.

Sources: Prescribers' Drug Reference. (2016, December 10). Sodium Chloride. Retrieved from: https://www.pdr.net/drug-summary/Sodium-Chloride-sodium-chloride-24245
Vallerand, A.H. & Sanosky, C.A. (2018, November 22). Sodium Chloride. Retrieved from FA Davis Plus: https://davisplus.fadavis.com/3976/meddeck/pdf/sodiumchloride.pdf
Monthly Index of Medical Specialities. (2011, May 11). Sodium chloride. Retrieved from: https://www.mims.com/philippines/drug/info/sodium%20chloride?mtype=generic
Lippincott Nursing Center. (2019, January 2). IV Fluids. Retrieved from: https://www.nursingcenter.com/getattachment/Clinical-Resources/nursing-pocket-cards/IV-Fluids/IV-Fluids-_January-
2019.pdf.aspx
Columbia University. (2006, July 14). IV Complications. Retrieved from Columbia Center for Teaching and Learning: http://ccnmtl.columbia.edu/projects/aegd/mod01_mec_ivcomp.html
Height/weight 50th percentile references taken from CDC: https://www.cdc.gov/growthcharts/data/set1/chart07.pdf; https://www.cdc.gov/growthcharts/data/set2/chart-03.pdf

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