Intravenous Solutions

Question 1

3 types of solutions

Answer 1

isotonic
hypotonic
hypertonic

Question 2

what differentiates the different solution types

Answer 2

relation to blood osmolality

Question 3

osmosis

Answer 3

less of a concentration trying to move to high concentration

Question 4

Isotonic solutions osmolality

Answer 4

close to the blood/extra cellular fluid

Question 5

Isotonic solutions

Answer 5

normal saline (0.9NS)
Lactated ringers (LR)

Question 6

indications of isotonic solution

Answer 6

expansion of the extracellular fluid volume

Question 7

examples of indications of isotonic solution

Answer 7

Trauma, loss of blood, postop surgery, dehydration, increasing blood pressure

Question 8

when would we NEVER use isotonic

Answer 8

congestive heart failure
pulmonary edema
sodium retention
renal failure

Question 9

hypotonic osmolality compared to blood

Answer 9

less than that of the blood

Question 10

hypotonic solution

Answer 10

half normal saline (0.45NS)

Question 11

what does hypotonic solution do to the cells

Answer 11

fluid goes into the cells, cells swell, cells can rupture

ECF into ICF

Question 12

indications for hypotonic solutions

Answer 12

replace cellular fluid

Question 13

examples of indications for hypotonic solutions

Answer 13

treatment of hypernatremia or hyperosmolar conditions
cellular dehydration
diabetic ketoacidosis/hyperglycemia

Question 14

when would we never use hypotonic solutions

Answer 14

cellular swelling
BRAIN INJURIES
intravascular depletion
decreased blood pressure
burns
trauma

Question 15

why do we not want to use hypotonic solution for intravascular depletion and low blood pressure

Answer 15

fluid is not going to stay in vascular

Question 16

why do we not want to use hypotonic solution in burns and trauma pts

Answer 16

the patients are already hypovolemic

Question 17

what can hypotonic solutions cause if pushed too far

Answer 17

hypovolemic

Question 18

hypertonic osmolality related to blood

Answer 18

exceeds that of blood

Question 19

hypertonic solutions

Answer 19

3% normal saline (3%NS)
D5% Normal Saline (D5NS)
D5 Lactated Ringers (D5LR)
D5 Half Normal Saline (D5.45NS)

Question 20

where are hypertonic solutions hung

Answer 20

ICU

Question 21

what is special about
D5% Normal Saline (D5NS)
D5 Lactated Ringers (D5LR)
D5 Half Normal Saline (D5.45NS)

Answer 21

these all start out as hypertonic because of the dextrose, but then the dextrose is metabolized and osmolality depends on what it was paired with

Question 22

D5% Normal Saline (D5NS)

Answer 22

hyper
iso

Question 23

D5 Lactated Ringers (D5LR)

Answer 23

hyper
iso

Question 24

D5 Half Normal Saline (D5.45NS)

Answer 24

hyper
hypo

Question 25

D5% Normal Saline (D5NS) D5 Lactated Ringers (D5LR) D5 Half Normal Saline (D5.45NS) cautions

Answer 25

increase blood sugar

Question 26

if we know that these solutions cause increase in blood sugar, when might we give them? D5% Normal Saline (D5NS) D5 Lactated Ringers (D5LR) D5 Half Normal Saline (D5.45NS)

Answer 26

hypoglycemic long acting insulin given and patient becomes NPO

Question 27

indications of hypertonic solutions

Answer 27

draw water from the cell (intracellular) into ECF causing cell to shrink. Used primarily when serum osmolality has decreased to dangerously low levels

Question 28

examples of indications for hypertonic solutions

Answer 28

cellular swelling/brain swelling cerebral edema hyponatremia (pulls sodium back into intravascular/ecf)

Question 29

cautions hypertonic solutions

Answer 29

may cause extracellular fluid volume excess may precipitate circulatory overload and dehydration can lead to pulmonary edema

Question 30

D5W (dextrose in water) indications and cautions

Answer 30

iso hypotonic avoid with patients with brain injury avoid during fluid resuscitation may cause hyperglycemia

Question 31

balanced crystalloid and plasma lyte are also used but not as common why

Answer 31

expensive

Question 32

Normal Saline (0.9NS)

Answer 32

isotonic

Question 33

Lactated Ringers (LR)

Answer 33

isotonic

Question 34

Half Normal Saline (0.45NS)

Answer 34

hypotonic

Question 35

3% Normal Saline (3%NS)

Answer 35

hypertonic

Question 36

D5% Normal Saline (D5NS)

Answer 36

hypertonic isotonic

Question 37

D5 Lactated Ringers (D5LR)

Answer 37

hypertonic isotonic

Question 38

D5 Half Normal Saline (D5.45NS)

Answer 38

hypertonic hypotonic

Question 39

D5 Water (D5W)

Answer 39

hypertonic hypotonic