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Parenteral Solutions: Osmolality and Osmolarity

Terms in this set (16)

Isotonic Fluids
0.9% Nacl Sodium Chloride
5% dextrose in water
Lactated Ringer's
Osmolarity of Isotonic Fluids
250-375 mOsm/L (similar to bodies natural osmolarity)
Action of Isotonic Fluids
Fluids used to expand the ECF compartment as no fluid shifts will take place
Isotonic fluid uses
Treat: Dehydration, fluid loss, hypernatremia
Hypotonic Fluids
0.45% sodium chloride
0.33% sodium chloride
0.25% dextrose in water.
Osmolarity of Hypotonic fluids
lower than 250 mOsm/L. The osmotic pressure gradient draws fluid from ECF into the cells, causing them to swell
Action of hypotonic fluids
used to hydrate cells and can deplete the circulatory system. Water moves from the vascular space to the intracellular space.
uses of hypotonic fluids
-used for pateints who have hypertonic dehydration (need to replace the fluid in cells)
-Water replacement
-Diabetic Ketoacidosis (after initial sodium and fluid replacement)
Hypertonic Fluids
-5% dextrose in 0.45% sodium chloride
-5% dextrose in 0.9% sodium chloride
-5% dextrose in lactated ringer's
-10% dextrose in water
-Colloids: albumin 25% plasma protein fraction, dextran, hetastarch
Osmolarity of Hypertonic Fluids
375 mOsm/L or higher which will draw water from the ICF space increasing ecf volume and causing cells to shrink
Action of hypertonic fluids
Will draw fluid from the cells and from interstitial space. Can decrease swelling in cells and increase plasma volume.
uses of hypertonic fluids
• Used to replace electrolytes
• Treat hypotonic dehydration
• Treat circulatory insufficiency and shock.
Isotonic Fluid Cautions
•Isotonic fluids can lead to fluid overload.
•Fluids can dilute the concentration of hemoglobin and lower hematocrit level.
•5% dextrose becomes hypotonic when the dextrose is metabolized.
Hypotonic solution cautions
can further exacerbate hypotension as fluid will leave vascular space
Hypertonic solutions cautions
•Hypertonic solutions are irritating to vein wall and may cause hypertonic circulatory overload.
•May be contraindicated in cardiac and renal failure patients due to increased risk of CHF and pulmonary edema.
•Give hypertonic solutions slowly to prevent circulatory overload.
A nurse is caring for a client who has a serum sodium level of 155 mEq/L. What solution would you give? hypertonic? hypotonic? isotonic? why?
hypotonic. The nurse should anticipate administering 1000mL 0.225% sodium chloride, which is a hypotonic solution, to gradually reduce hypernatremia without causing cerebral edema.
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