When administering sodium chloride from flexible plastic containers, do not connect in series, pressurize without fully evacuating the container's residual air, or use a vented intravenous administration set with the vent in the open position.
Such use could result in air embolism. Central access should be obtained for continued use. Monitor peripheral administration of hypertonic solutions carefully for potential extravasation and local tissue damage. Additional solutes such as dextrose or other electrolytes e. Do not mix or administer hypotonic or hypertonic sodium chloride injection solutions through the same administration set with whole blood or cellular blood components. IV Push 0. Intermittent IV Infusion 0. Intraosseous Administration For emergent fluid resuscitation, 0.
Inhalation Solution for Nebulization To minimize or prevent bronchospasm, administer a bronchodilator e. Inhaled hypertonic sodium chloride has been administered via jet and ultrasonic nebulization.
Hold bottle upright. Give short, firm squeezes into each nostril. Do not aspirate nasal contents back into bottle. Small Children and Infants: Use drops. Put drops in each nostril and have the child remain on their back for 1 to 2 minutes. Rinse bottle tip with hot water and wipe with a clean towel after each administration. To avoid contamination and prevent the spread of infection, do not use the bottle dispenser for more than 1 person to prevent the spread of infection. Ophthalmic solution Do not use if solution changes color or becomes cloudy.
Apply to affected eye and replace cap after use. To avoid contamination, do not touch the tip of the dispenser to any surface e.
Ophthalmic ointment Do not use if ointment is difficult to dispense or if particles are visible in the product. Generic: - Discard product if it contains particulate matter, is cloudy, or discolored - Discard unused portion. Do not store for later use. Saljet Rinse: - Discard product if it contains particulate matter, is cloudy, or discolored - Discard unused portion. Hypersensitivity and infusion reactions may occur with intravenous sodium chloride infusion.
Immediately stop the infusion and institute appropriate therapeutic countermeasures if signs or symptoms of hypersensitivity occur. Use sodium chloride with great caution in patients with preexisting hypernatremia, hyperchloremia, metabolic acidosis, or risk factors for such conditions. Intravenous solutions should be used with particular care in patients at risk for hypervolemia or other conditions that may cause sodium retention and fluid overload such as patients with primary or secondary hyperaldosteronism.
In patients with cardiac disease, sodium chloride administration and subsequent sodium retention may exacerbate hypertension, edema, and heart failure. In addition, because sodium chloride is primarily excreted by the kidney, administration to patients with renal disease, including renal artery stenosis, nephrosclerosis, renal impairment, or renal failure may result in significant sodium and chloride retention.
Additionally, patients with diabetic ketoacidosis may be at risk for cerebral edema after rapid administration of a crystalloid e. It is recommended to avoid routine volume expansion in newborns without evidence of acute blood loss. In patients with organ dysfunction, monitor respiratory status and tissue perfusion, as well as changes in clinical condition.
In addition, central pontine myelinolysis CPM , a noninflammatory demyelinating condition, can occur when hyponatremia is corrected too quickly. Patients with severe malnutrition, alcoholism, or advanced liver disease may be more susceptible to CPM and sodium replacement therapy should be tailored to stay well below established limits.
Risk for developing hyponatremia is also increased in those with psychogenic polydipsia and those who are receiving concurrent medications that increase the risk of low serum sodium.
Patients with hypoxemia and those with underlying central nervous system disease are at risk for developing hyponatremic encephalopathy. Females particularly premenopausal are also at higher risk. Carefully consider fluid status in hyponatremic patients with hepatic disease e. Water retention and dilutional hyponatremia are common in patients with advanced disease and should be treated with sodium and fluid restriction, as well as diuretics.
Sodium supplementation may aggravate edema. In addition, patients with advanced liver disease may be more susceptible to central pontine myelinolysis CPM ; sodium replacement therapy should be tailored to stay well below established limits.
Hemolysis of red blood cells can occur during the infusion of hypotonic solutions. In the presence of a hypotonic fluid, water enters the red blood cells across a diffusion gradient, causing the cells to swell and burst. After lysis, the intracellular contents of the cells e.
Because of this phenomenon, isotonic or near-isotonic solutions are preferred for fluid administration. Normal saline 0. In contrast, 0. Hypotonic solutions should never be used for fluid resuscitation or rehydration; however, they are sometimes used in patients with high serum osmolarity e. Additionally, hypotonic saline solutions offer a maintenance infusion option with less sodium content, which may be desirable in specific circumstances e.
However, the most hypotonic fluid that can be safely administered is 0. The risk of hemolysis increases as the tonicity decreases ; of the commercially available saline products, 0.
Mixing hypotonic saline solutions with dextrose increases their tonicity and makes the overall solution approach isotonicity, making it feasible to administer an intravenous infusion with a lower sodium content. For example, 0. Because hemolysis is accentuated by an increased ratio of hypotonic solution to blood and prolonged cell contact time with the solution, it has been suggested that administering hypotonic solutions at a slower rate or through a central line may decrease the risk of cell lysis; however, hemolysis can still occur with such precautionary measures and use of any hypotonic solution in patients should be used with extreme caution.
According to the manufacturer, it is not known whether sodium chloride can cause fetal harm or affect reproduction capacity; only administer sodium chloride during pregnancy if it is clearly needed.
However, normal saline 0. Saline nasal preparations and topical solutions are safe for use during pregnancy. According to the manufacturer, it is not known whether sodium chloride is excreted in human milk. Because 0. Use caution when using sodium chloride bacteriostatic injection, as the benzyl alcohol preservative is associated with the development of metabolic acidosis, kernicterus, and intraventricular hemorrhage in the neonatal population; bacteriostatic injection is contraindicated for direct use in the neonatal population.
Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. Bacteriostatic sodium chloride products contain benzyl alcohol and are contraindicated in neonates and premature neonates. Gasping syndrome is characterized by central nervous depression, metabolic acidosis, and gasping respirations.
If a sodium chloride solution is required for preparing medications or intravascular flush, only preservative-free injection should be used. Many physiological changes occur during the first weeks of life that affect the neonate's handling of fluid and sodium, especially in premature neonates. Carefully assess fluid and sodium status and adjust therapy as appropriate. In general, volume expansion in neonates should only be used when clearly needed e.
Premature neonates younger than 30 weeks gestational age should receive fluid resuscitation with 0. Children, including neonates and infants, are at increased risk of developing hyponatremia and hyponatremic encephalopathy. Rapid correction of hypo- or hypernatremia requires an experienced clinician. Due to the risk of serious neurologic complications, dosage, rate, and duration of administration should be determined by a physician experienced in intravenous fluid therapy.
Sodium chloride ophthalmic formulations i. There are no data to determine if geriatric patients respond differently to sodium chloride compared to younger patients.
However, sodium chloride is excreted by the kidney, and elderly patients are more likely to have decreased renal function. In general, dose selection for the elderly should be cautious and start at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, and cardiac function as well as concomitant disease or drug therapy.
Monitor renal function in the elderly when receiving sodium chloride. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. The presence of other medical problems may affect the use of this medicine.
Make sure you tell your doctor if you have any other medical problems, especially:. A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins after it has been diluted. During the procedure, you will be awake and be asked questions about how you are doing by the health care team. This helps them to react quickly to any problems you might have and to keep side effects to a minimum.
It is very important that your doctor check your progress closely while you are receiving this medicine to make sure that the medicine is working properly and to check for unwanted effects. This medicine may cause serious problems eg, hypokalemia, acidosis, heart failure, pulmonary edema, or fluid retention and are more likely to occur if sodium chloride is given for a long time or in high doses. Talk to your doctor if you have concerns. Along with its needed effects, a medicine may cause some unwanted effects.
Although not all of these side effects may occur, if they do occur they may need medical attention. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Sodium and potassium are electrolytes in the fluid outside and inside your cells. Your kidneys , brain , and adrenal glands work together to regulate the amount of sodium in your body. Chemical signals stimulate the kidney to either hold on to water so it can be reabsorbed into the bloodstream or get rid of excess water through the urine. This leads to an increase in blood volume and blood pressure. Decreasing your sodium intake can lead to less water being absorbed into the bloodstream.
The result is a lower blood pressure. You can treat the irritation, depending on the area, by rinsing the spot with plain water or getting fresh air. Eating too much salt is linked to:. Saline solutions are typically administered intravenously, or through the vein. High concentrations of saline solutions can have side effects of redness or swelling at the injection site. Sodium deficiency is usually a sign of an underlying disorder. The name for this condition is hyponatremia. It can be due to:.
Excessive and continuous sweating without proper hydration is also a potential cause, especially in people who train and compete in long endurance events like marathons and triathlons. About 75 to 90 percent of our sodium intake comes from salt, or sodium chloride. Salt provides an essential mineral sodium that our bodies use for functions such as maintaining blood pressure and absorbing nutrients. You can also use salt for seasoning foods, cleaning your household items, and addressing certain medical issues.
The American Dietary Guidelines suggest you eat less than 2, mg of sodium per day. You can do this by eating less processed foods, like cold cuts and prepackaged foods, and cooking meals at home. What foods have the least amount of sodium? Too much salt can lead to bigger health concerns like high blood pressure, heart disease, and kidney disease. Lowering your salt intake while increasing how much potassium you get can help lower your risk for those conditions.
You should consult your doctor before adding more sodium chloride to your diet. Most people exceed the recommended amount, but people who drink excessive amounts of water, have persistent diarrhea, or participate in long endurance events may have sodium deficiency. In these cases, good oral hydration may help. In more severe cases, a healthcare professional may need to provide intravenous IV saline solution to restore hydration and electrolytes.
It's often recommended to reduce sodium to lower blood pressure. Here are 6 reasons why restricting sodium too much can be harmful. People talk about the health benefits of pickles, citing weight loss, diabetes management, and even anticancer properties, too.
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