How does the Doc order the rate in IVF administration?

[jamst149]

i.e. he orders 125ml/hr NSS

Where does he come up with the 125? Can't see to hunt down an answer on this. Is it to simplistic to assume its simply based on hydration status? For example a dehydrated pt recieves a higher rate of admiinistration whereas a edematous pt would receive a lower rate? But I thought that was the reason for the hypotensive vs hypertensive fluids. What gives?

For some reason I would think that # must be calculated somehow but I just seem to find a calculation anywehere.

edit: Should note I'm thinking in terms of maintenance i.e. not a pt in the ED who is hypotensive or some such instance.

[NursingAgainstdaOdds]

I was wondering this the other day myself.

Aside from hydration status, and BP, there is also the concern for ensuring a CHFer doesn't go into overload...

I'd love to know where they come up with these numbers though.

[CardioTrans, BSN, RN]

Some docs look at lab values to determine the rate. For example......if a pt had a BNP or >1100..... they may order a rate of 20-30cc/hr....if any...... they may also look at the patient's BUN and creatnine.......their electrolytes etc. Our dieticians sometimes "recommend" a certain amt of fluid bolus based on the caloric intake etc.

[island40]

The average person needs a minimum of 2500mL of fluid every day: daily losses from urination, respiration, digestion... For optimum hydration 3000mL is best. Divide that out and 125mL an hour every 24 hours gives the person optimum hydration.

[tiij]

In paediatrics. you would go by this rule

the "4,2,1" rule

4ml/hr * the first 10kg

2ml/hr * the second 10kg

and 1ml/hr for every subsequent kg.

So a 40 kg child most likely will get 80ml/hr full maintenance.

But i think island40 hit the nail on the head for your scenario. I just thought id put it out there..

[Altra, BSN, RN]

Is it to simplistic to assume its simply based on hydration status? For example a dehydrated pt recieves a higher rate of admiinistration whereas a edematous pt would receive a lower rate? But I thought that was the reason for the hypotensive vs hypertensive fluids.

Do you mean hypo-/iso-/hypertonic fluids?

See island40's post.

[Babs0512]

I found a link that gives suggestions for euvolaemic adults and proper IV hydration:

http://vitualis.wordpress.com/2006/05/01/maintenance-iv-fluids-in-euvolaemic-adults/

Hope this helps

Blessings

[zacarias, ASN, RN]

I found a link that gives suggestions for euvolaemic adults and proper IV hydration:

http://vitualis.wordpress.com/2006/05/01/maintenance-iv-fluids-in-euvolaemic-adults/

Hope this helps

I like that website posted above, but it's recommendations (going from NS to D5W and back again..and the other using 0.18 NS) I never see used. I am one of those nurses who arrives on shift analyzing the medical orders and looking at the medical plan of care. Wondering whether the patient's pillow is in the right spot is last on my mind (although I do get to that).

I'm a nurse in so many ways but trapped in a wanna be medical practitioner's body. Oh well...

[Babs0512]

I have actually seen Doc's order IVF similarly to the link I gave you. Intraoperatively, anesthesia sometimes uses LR, than a bag of D5LR, then Hespan, then back to LR. I assume due to NPO status for extended periods. Generally speaking, however, I don't usually see IVF ordered this way. I found the link interesting, so I posted it.

Blessings

[andrewmccute]

Hydration status, estimated weight and the assumption of the disease of the patient, i think, are the factors that the doctor see when giving an order of IVF

[justt139]

Can someone answer this question:

How many 1L bags will be administered.

Ordered: 1/2 NS @ 80 mL/h over 12 hours.

[Babs0512]

960 ml will have infused over the 12 hours - 40 ml less than 1 liter.