Exam 2 IV Fluids

  1. Hypotonic Fluids
    • 0.45% Saline - treats hypernatremia and uncontrolled hyperglycemia, used as maintenance solution
    • 0.33% Saline
  2. Hypertonic Fluids
    • 3%-5% Saline - treats symptomatic hyponatremia and trauma patients with head injury
    • D5 in 0.45% Saline - used as maintenance solution
    • D5 in 0.9% Saline - used to treat metabolic alkalosis and volume deficits in patients with hyponatremia
    • D5LR
    • D10W - used in parenteral nutrition
  3. Isotonic Fluids
    • 0.9% Saline - used to expand intravascular volume and replace ECF losses (replacement of fluid and sodium losses)
    • D5 in 0.25% Saline - used to replace hypotonic losses and treat hypernatremia
    • LR - used to treat hypovolemia, burns, and GI fluid losses (contraindicated in patients with alkalosis or lactic acidosis)
    • D5W - treats hypernatremia
    • Normosol-R - treats acute losses of ECF - Hypovolemia
  4. How do Hypotonic solutions act when infused?
    • dilutes the ECF
    • moves water from ECF into the cells and interstitial spaces
    • Treats hypernatremia
    • Good for maintenance
    • Not good for replacement because they deplete ECF and lower BP
    • Monitor for cerebral edema
    • D5W (technically isotonic) acts as a hypotonic solution because the dextrose quickly metabolizes. Causes equal expansion of ECF and ICF
  5. How do Isotonic solutions act when infused?
    • expands only ECF, no movement into cells
    • ideal treatment for ECF volume deficits (hypovolemia)
  6. How do Hypertonic solutions act when infused?
    • Initially raises the osmolality of ECF and expands volume
    • Draws water out of cells
    • Treatment of hyponatremia and trauma patients with head injury
    • Monitor BP, lung sounds, serum sodium levels due to risk of intravascular fluid volume excess
  7. Colloids
    • AKA volume expanders or plasma expanders
    • Contain large molecules that increase oncotic pressure and pull fluid into the blood vessels
    • Restores blood volume
    • Types of colloids are: human plasma products (albumin, fresh frozen plasma, blood) and semisynthetics (dextran, starches)
    • Risk of circulatory overload
    • Monitor vital signs and urine output, S&S of fluid volume excess (hypervolemia)
    • Anticoagulation properties - semisynthetics more so than human plasma products
  8. Total parenteral nutrition
    • TPN
    • A hypertonic solution containing 20% to 50% dextrose, proteins, vitamins, and minerals that is administered into the venous system.
Card Set
Exam 2 IV Fluids
Crystalloid Solutions Table in Lewis p 293