IV Fluids - Colloids, Crystalloids, Isotonics
Terms in this set (12)
Contain large molecules that do not pass through semipermeable membranes so that when infused, they remain in the vascular system to expand the intravascular volume (draws fluid from extravascular spaces by oncotic pressure) - "Volume Expanders". Work like hypertonic crystalloids but don't require as much volume; last longer than crystalloids. Used for hypoproteinemia, malnourished
states, pts who need plasma volume expansion but can't tolerate the large infusions of crystalloids
Are solutes that are easily mixed and dissolve in a solution. The solutes may be electrolytes or nonelectrolytes (dextrose) which are small molecules that flow across the semipermeable membrane, allowing transfer from bloodstream into cells and body tissues. This may increase the fluid volume in both interstitial and intravascular spaces. There are 3 types of crystalloids: Isotonic, Hypotonic, and
ISOTONIC - NS - What it does
Fluid in each compartment remains within its compartment
(no shift occurs) - cells neither shrink nor swell. Water
ISOTONIC - NS - Why
To treat low ECF -- fluid volume deficit from hemorrhage,
severe vomiting, diarrhea, GI suction, wounds, shock, mild
hyponatremia, metabolic acidosis such as DKA and
hypercalcemia. NS is fluid of choice for resuscitation and
only fluid used with blood administration.
ISOTONIC - NS - Nursing Considerations
Remember that because 0.9% sodium chloride replaces
extracellular fluid, it should be used cautiously in certain patients, such as those with cardiac or renal disease, because of the potential for fluid volume overload.
ISOTONIC - LR - What is does
Electrolyte content is most closely related to the composition of the blood.
ISOTONIC - LR - Why
Chosen over NS for pt requiring electrolyte replacement (such as surgery or burns). Used to replace GI fluid loss, burns,
trauma, acute blood loss, hypovolemia due to third spacing
ISOTONIC - LR - Nursing considerations
LR is metabolized in the liver, which converts the lactate to
bicarbonate. Don't give LR to patients who can't metabolize
lactate (liver disease or those experiencing lactic acidosis). Because a normal liver will convert it to bicarbonate, LR
shouldn't be given to a patient whose pH is greater than 7.5. Because it does contain some potassium, use Isotonic and
Hypotonic since dextrose is rapidly metabolized. Free
water initially dilutes ECF, provides for kidneys. D5W Sugar water; may be used to dilute extra Na in Hypernatremia.
caution in patients with renal failure.
ISOTONIC - D5W - What it does
Isotonic and Hypotonic since dextrose is rapidly metabolized. Free water initially dilutes ECF, provides for kidneys
ISOTONIC - D5W - Why
Sugar water; may be used to dilute extra Na in Hypernatremia.
ISOTONIC - D5W - Nursing Considerations
D5W should not be used alone to treat hypovolemia
because it dilutes electrolyte concentrations. Contraindicated in resuscitation (doesn't stay in intravascular space), early postop (surgical stress increases ADH), or in patients with
known or suspected increased ICP (hypotonic properties will swell brain cells).
For all isotonic:
Hypovolemia treated with isotonic can quickly turn to
hypervolemia if too fast or too long so watch VS, LOC,
edema, lung sounds, heart sounds, and general response to
IV therapy; Keep HOB elevated unless contraindicated