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IV Fluids - HYPOTONIC & HYPERTONIC

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HYPOTONIC - Types
0.45% NaCl
0.33% NaCl
2.5% dextrose water
HYPOTONIC - What is does
Infusion causes an unequal solute concentration among the fluid compartments -- lowers the serum osmolality within the vascular space, causing fluid to shift from the intravascular
space to both the intracellular and interstitial spaces.
These solutions will hydrate cells, although their use may deplete fluid within the circulatory system.
HYPOTONIC - Why
Helps kidneys excrete excess fluids and electrolytes;
provide free water and NaCl; treats intracellular dehydration (DKA, hyperosmolar hyperglycemia); shifts fluid from
vascular bed into cells and interstitial spaces
HYPOTONIC - Nursing considerations
Can worsen hypovolemia and hypotension; can cause vascular collapse; monitor for volume deficit; older adults may
show confusion or dizziness. NEVER give to increased ICP, liver disease, trauma or burns due to potential for hypovolemia.
HYPERTONIC - 3% NaCl - What it does
Draws water out of the intracellular space, increasing
extracellular fluid volume. Because of this property, hypertonic
solutions are used as volume expanders. Hypertonic
solutions affect renal filtration mechanisms and can cause
hypervolemia.
HYPERTONIC - 3% NaCl - Why
Severe hyponatremia and patients with cerebral edema;
will raise Na in bloodstream while osmosis removes water from intracellular space causing volume expansion.
HYPERTONIC - 3% NaCl - Nursing considerations
Used in critical situations; give slowly to avoid fluid overload and pulmonary edema. Store hypertonic NaCl solutions
away from other floor stock and monitor for s/o hypervolemia due to fluid shifts; Do not give to renal or cardiac conditions who are dehydrated; Do not give to pts with cellular
dehydration such as DKA (diabetic ketoacidosis).
HYPERTONIC - D5 ½ NS, D5LR, D10W, D50- Why
Adds calories to Na, electrolytes or water. D50 used in
severe hypoglycemia.