Isotonic, hypotonic, and hypertonic IV fluid types and electrolyte replacement therapy with their key nursing considerations.
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- How does the osmolality of an isotonic IV solution compare to plasma?
- It is approximately equal to plasma osmolality
- Name a commonly used isotonic IV fluid
- 0.9% NaCl (normal saline)
- Name a second commonly used isotonic IV fluid
- Lactated Ringer's solution
- What is the primary clinical use of isotonic IV fluids?
- To expand extracellular fluid volume, such as in hypovolemia or hemorrhage
- What is the main nursing risk of infusing large volumes of isotonic fluid?
- Fluid (circulatory) overload
- How does the osmolality of a hypotonic IV solution compare to plasma?
- It is lower than plasma osmolality
- Name a commonly used hypotonic IV fluid
- 0.45% NaCl (half-normal saline)
- What is the primary clinical use of hypotonic IV fluids?
- To treat cellular dehydration/hypernatremia by shifting water into cells
- What is the main nursing risk of hypotonic IV fluids?
- Cell swelling, including risk of cerebral edema
- How does the osmolality of a hypertonic IV solution compare to plasma?
- It is higher than plasma osmolality
- Name a hypertonic IV fluid used for severe hyponatremia
- 3% NaCl (hypertonic saline)
- Name a dextrose-containing hypertonic IV fluid
- D5 0.9% NaCl (D5NS)
- What is the primary clinical use of hypertonic IV fluids?
- Treating severe hyponatremia and cerebral edema by pulling fluid into the vascular space
- What is a key nursing precaution when administering hypertonic saline?
- Infuse slowly via pump and monitor closely for fluid overload
- Why is D5W considered physiologically hypotonic even though it is isotonic in the bag?
- The dextrose is metabolized quickly, leaving behind free water that dilutes plasma