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