I-V fluids...

IV fluids; the occasional patient will still require some supplemental IV fluids or antibiotics at discharge. Before writing, please request social work to be sure the nursing facility can do IVs and IV antibiotics (be sure to check how frequently they could give antibiotics).  Delays in discharge will be avoided, by placing a PICC line if antibiotics or longer-term IV fluids will be necessary.


Fluid goals; in the hospital or skilled nursing facility, when in transition from total IV fluid support to the patient taking all their fluids orally can be slow and unpredictable. One technique to support your patient in this process is to write oral fluid goals with IV back-up. This technique allows the patient the chance to meet their fluid goals orally in a more natural fashion, yet provides a "safety net" to prevent them from becoming dehydrated. It is suggested that you write your fluid goals by the nursing work shift.  This avoids the day shift, ignoring the patient and dumping all the fluid intake on the evening shift, which is unnatural, and untenable.  (Believe me, this happens)

Here is an example; elderly patients require approximately 30 cc/kg/24 hours as maintenance fluid. A 70 kg patient would require 2100 cc/24 hours.  A suggested order would be following: