Intravenous Solutions Flashcards
3 types of solutions
isotonic
hypotonic
hypertonic
what differentiates the different solution types
relation to blood osmolality
osmosis
less of a concentration trying to move to high concentration
Isotonic solutions osmolality
close to the blood/extra cellular fluid
Isotonic solutions
normal saline (0.9NS)
Lactated ringers (LR)
indications of isotonic solution
expansion of the extracellular fluid volume
examples of indications of isotonic solution
Trauma, loss of blood, postop surgery, dehydration, increasing blood pressure
when would we NEVER use isotonic
congestive heart failure
pulmonary edema
sodium retention
renal failure
hypotonic osmolality compared to blood
less than that of the blood
hypotonic solution
half normal saline (0.45NS)
what does hypotonic solution do to the cells
fluid goes into the cells, cells swell, cells can rupture
ECF into ICF
indications for hypotonic solutions
replace cellular fluid
examples of indications for hypotonic solutions
treatment of hypernatremia or hyperosmolar conditions
cellular dehydration
diabetic ketoacidosis/hyperglycemia
when would we never use hypotonic solutions
cellular swelling
BRAIN INJURIES
intravascular depletion
decreased blood pressure
burns
trauma
why do we not want to use hypotonic solution for intravascular depletion and low blood pressure
fluid is not going to stay in vascular
why do we not want to use hypotonic solution in burns and trauma pts
the patients are already hypovolemic
what can hypotonic solutions cause if pushed too far
hypovolemic
hypertonic osmolality related to blood
exceeds that of blood
hypertonic solutions
3% normal saline (3%NS)
D5% Normal Saline (D5NS)
D5 Lactated Ringers (D5LR)
D5 Half Normal Saline (D5.45NS)
where are hypertonic solutions hung
ICU
what is special about
D5% Normal Saline (D5NS)
D5 Lactated Ringers (D5LR)
D5 Half Normal Saline (D5.45NS)
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
D5% Normal Saline (D5NS)
hyper
iso
D5 Lactated Ringers (D5LR)
hyper
iso
D5 Half Normal Saline (D5.45NS)
hyper
hypo
D5% Normal Saline (D5NS)
D5 Lactated Ringers (D5LR)
D5 Half Normal Saline (D5.45NS)
cautions
increase blood sugar
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)
hypoglycemic
long acting insulin given and patient becomes NPO
indications of hypertonic solutions
draw water from the cell (intracellular) into ECF causing cell to shrink. Used primarily when serum osmolality has decreased to dangerously low levels
examples of indications for hypertonic solutions
cellular swelling/brain swelling
cerebral edema
hyponatremia (pulls sodium back into intravascular/ecf)
cautions hypertonic solutions
may cause extracellular fluid volume excess
may precipitate circulatory overload and dehydration
can lead to pulmonary edema
D5W (dextrose in water) indications and cautions
iso hypotonic
avoid with patients with brain injury
avoid during fluid resuscitation
may cause hyperglycemia
balanced crystalloid and plasma lyte are also used but not as common why
expensive
Normal Saline (0.9NS)
isotonic
Lactated Ringers (LR)
isotonic
Half Normal Saline (0.45NS)
hypotonic
3% Normal Saline (3%NS)
hypertonic
D5% Normal Saline (D5NS)
hypertonic
isotonic
D5 Lactated Ringers (D5LR)
hypertonic
isotonic
D5 Half Normal Saline (D5.45NS)
hypertonic
hypotonic
D5 Water (D5W)
hypertonic
hypotonic
