For TFI:? Help with understanding IV infusion

nurseprnRN, BSN, RN · Mar 25, 2012

there's no such thing as 20% kcl.

i haven't the foggiest idea. this site (below) has something like 150 possible choices for this acronym, but none sounds like it meets these criteria (twin falls, idaho, anyone?).

now i won't sleep trying to figure it out, so would you please ask the pharmacist or a nurse and tell us???

tfi meaning - acronym attic

Double-Helix, BSN, RN · Mar 25, 2012

I'm guessing it means Total Fluid Intake. Is the patient NPO? So the rate of the fluid would be set so that the patient is getting their full fluid requirement from the IV in a 24 hour period.

This is clearly not a standard abbreviation, which means it's probably specific to you facility and a nurse or MD there should be able to tell you what it means.

DeusExMachina · Mar 25, 2012

Figured it out... for total intake apparently. It's a maintenance line. So the KCl is for electrolytes, and not sure what the dextrose is intended to do?

DeusExMachina · Mar 25, 2012

Oh yea, you beat me to it! Yes, the patient is NPO.

Double-Helix, BSN, RN · Mar 25, 2012

Dextrose in IV fluid provides a small amount of sugar (carbohydrates), or energy, for the cells. It can keep the body from using up protein for energy metabolism when the patient is unable to eat.

nurseprnRN, BSN, RN · Mar 25, 2012

three liters a day of d5w contains a total of ... 600 calories. not enough to prevent protein loss related to malnutrition.

DeusExMachina · Mar 25, 2012

three liters a day of d5w contains a total of ... 600 calories. not enough to prevent protein loss related to malnutrition.

in that case, i'm completely stumped, i don't know why this pt is not getting something else to replace calories? the patient is 10 years old, but still seems like it would not be enough.

Double-Helix, BSN, RN · Mar 25, 2012

Oh, I wasn't referring specifically to the amount of dextrose in the fluid, just the purpose of dextrose in general.

If the patient is only going to be NPO for a short time, it isn't necessary to give anything more for nutrition. Remember that our bodies can last a month without food, but only a few days without water. Providing hydration is enough. Also during acute illness, it's often necessary to preserve the body's energy, so to speak, so that it can focus on recovering. Keeping the patient NPO allows the gut to rest and not work to digest food.

Also remember that we can't always give adequate nutrition through a vein. If the patient can't eat for some reason (maybe a high respiratory rate, they just had surgery, they have a problem with their GI tract) then the only option is parenteral nutrition. You may know that TPN (total parenteral nutrition) has to be given though a central line. While we can give PPN (partial parenteral nutrition) through a peripheral vein, it can still be damaging to the vein (and it's expensive) so we don't use it unless we really need it.

Esme12, ASN, BSN, RN · Mar 26, 2012

without knowing the child's diagnosis, lab values...it's impossible to say exactly why he is receiving fluids the following sites/info may help.

index icufaqs.org

isotonic

ns volume expander

blood transfusion

hypercalcemia

diabetic ketoacidosis

d5w dehydration

hypernatremia

lr burns

gi fluid loss

blood loss

hypovolemia due to 3rd spacing

hypotonic

1/2ns hypertonic dehydration (when cells shrink)

ng suctioning

diabetic ketoacidosis

hypertonic

d5half diabetic ketoacidosis

d5ns hypotonic dehydration (when cells swell)

siadh

addisonian crisis

5% dextrose and water is an isotonic solution that has an osmolarity of 253 and ph of about 4.5 to 5.0. it provides calories and free water. 5% dextrose in one liter of water contains 5 grams of dextrose per every 100ml which gives 170 calories per liter of fluid. the dextrose in iv solutions is metabolized very rapidly since it is a simple sugar which leaves behind plain old water. this water is able to cross all cell and tissue membranes to go into the various fluid compartments where is it needed.

and from our beloved daytonite(rip)........

attachment 5949 chart of commonly used iv solutions

attachment 5812 chart of commonly transfused blood products on post #22 of this thread is a description of hypotonic, isotonic and hypertonic iv solutions with a link to a listing of which iv fluids fit into each category. https://allnurses.com/nursing-student-assistance/any-good-iv-127657.html

DeusExMachina · Mar 26, 2012

He is a post-op perforated appy pt with an NG tube, and I was told it was for fluid maintenance. There were no other lab values besides pre-op blood work. Thanks for all the explanations, very appreciated and super helpful!