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Ebook Boh’s pharmacy practice manual - A guide to the clinical experience (4E): Part 2

(BQ) Part 2 book “Boh’s pharmacy practice manual - A guide to the clinical experience” has contents: Fluid and electrolyte therapy, enteral nutrition, parenteral nutrition, pharmacy calculations, clinical pharmacokinetics, clinical drug monitoring, pain management, vaccines and pharmacists as immunizers, and other contents. | 10 Fluid and Electrolyte Therapy Pauline A. Low This chapter provides reference information to assess each of the general approach elements to intravenous (IV) fluid and electrolyte therapy included in Box 10.1. The information in this chapter must be used in the context of good clinical judgment. Fluid Distribution Within the Body Total Body Water ■■ The amount of water present within the body is described as total body water (TBW). TBW for adults is estimated by using Equation 10.1. Total body water (L) = Adult males: weight (kg) × 0.6 Adult females: weight (kg) × 0.4 (10.1)   ■■ The percentage of body weight composed of water, declines as we age. Newborns typically have around 75% to 85% body weight as water, whereas adult males have 60% and females about 40% (variable; these estimations are not valid for obese patients or patients with larger than average muscle mass).1 ■■ Most body water is housed within cells. Since adult males generally have a higher muscle cell mass than adult females, they will have a higher volume of body water (accounted for in the equation by applying a higher multiplication factor). ■■ TBW is used to help select an appropriate IV fluid as well as to ­provide information for fluid and electrolyte dosing. 360 0002046822.INDD 360 1/21/2014 9:48:07 AM Chapter 10   Fluid and Electrolyte Therapy 361 Box 10.1  General Approach to IV Fluid/Electrolyte Therapy 1.  Determine clinical goals based on the specific patient. 2.  Identify which IV fluids and/or electrolytes will assist with achieving clinical goals and make appropriate selection. Consider the following: ■■ IV access (central or peripheral IV line) ■■ Oral intake capability of patient ■■ All sources of fluids and/or electrolytes ■■ IV fluid and electrolyte distribution characteristics 3.  For fluids: determine volume needs and the associated fluid rate. ■■ Consider maintenance fluid needs as well as replacement of excessive losses and requisite electrolyte content 4.  For .