NS vs USDA Salt Intake

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Normal Saline has 9grams of NaCl per 1 liter.

A common rate of infusion is 100-150mL/hr.

As an example: a patient is getting 100mL/hr over 24hrs. In other words, the patient will receive 21.6grams of NaCl within the 2.4L of Normal Saline being administered.

In the 2015-2020 Dietary Guidelines for Americans, the USDA recommends

I am missing something big here...

Specializes in Neuro, Telemetry.

Look into how isotonic solutions are used. The intent is to keep the fluid in the vasculature. If you over analyze how much "salt" is in the NS bag and choose a hypotonic solution to infuse with, where does the fluid ultimately end up? What could happen to the cells? While use there obviously is NaCl in the NS solution, the salt there is not being utilized by the body as dietary salt, it is serving a purpose in hydration of the body. While slow increases of blood sodium levels will occur, it is not usually enough to cause high sodium level or further disease processes. Since it is not generally a long term therapy, the body will excrete what it is not using to retain homeostasis in most case.

Also consider then maintenance therapy is not usually going to be 100ml/hr for days upon days. 100+ml/hr is generally used for dehydration, polyuria, and so on. Then a maintain with rate will be 25-75 once proper hydration is attained. If adverse reaction are noted from the NS, then the rate is either reduced or therapy is changed.

Dont nut think about how much salt the patient is getting, because that is not what the NS is being used by the body for. Focus on your F&E balance and how the solution types effect the body.

Specializes in Neuro, Telemetry.

You might also see salt wasting diuretics used if sodium is a concern for a patient recieving NS. It's about looking st the whole picture, not just one element. You'll get there.

Check your chemistry. The USDA guidelines are for

Yes, they're still getting more than the USDA recommended dietary intake, but not as much as you calculated (8.4g, not 21.6g). And you should think of NS like any drug, so route of administration matters, physiologically. The NS is not being absorbed through the digestive system. 0.9% saline is approximating isotonic concentration of Na and Cl in "normal" serum, and is often being administered as an intravascular volume expander, as pp noted.

YES! that is what i was overlooking:

Na: sodium

NaCl: one form of salt

And a second yes! NS is not going from the GI to liver to systemic vessels like something PO is; it is going straight into systemic vessels.

I will assume that sodium PO has a higher degree of absorption than sodium in NS due to route of administration... I'll look up the specifics on my own time.

Thank you for the responses!

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