IV FLuid Overview

Question 1

What are the 3 types of IV fluids ?

Answer 1

• Isotonic solutions
• Hypotonic solutions
• Hypertonic solutions

Question 2

What type of fluid goes into the vascular space and stays there ?

Answer 2

Isotonic solutions

Tip: Isotonic solutions –> “stay where I put it”

Question 3

What are examples of Isotonic solutions ?

Answer 3

• Normal Saline (NS)
• Lactated Ringers (LR)
• D5W
• D51/4 NS

Question 4

In what situations would Isotonic Solutions be appropriate ?

Answer 4

In clients’s who have lost fluids through…

• Nausea
• Vomiting
• Burns
• Sweating
• Trauma

Question 5

What is the basic solution used when administering blood ?

Answer 5

Normal Saline

Question 6

ALERT

In what types of Client’s can you not use Isotonic Solutions ?

Answer 6

Client’s with

• Hypertension
• Cardiac disease
• Renal disease

Question 7

What is the best Isotonic solution to use with shock and why ?

Answer 7

Lactated Ringers B/c it has more electrolytes

Question 8

Hypernatrremia is an alert only when what ?

Answer 8

Only when administering isotonic solutions that contain sodium

Question 9

Where do Hypotonic solutions go ?

Answer 9

Go into the vascular space and then shifts out into the cells to replace cellular fluid

Question 10

Hypotonic solutions are what ?

Answer 10

Hydrating solutions

Question 11

Hypotonic solutions rehydrate but do not cause what ?

Answer 11

HTN

Question 12

What are examples of Hypotonic Solutions ?

Answer 12

• D2.5W
• 1/2 NS
• 0.33% NS

Question 13

What are Appropriate uses for Hypotonic solutions ?

Answer 13

For client’s who have Hypertension, renal disease, or cardiac disease and need fluid replacement because of Nausea, vomiting, burns, hemorrhage, etc.

Question 14

When else are Hypotonic solutions used ?

Answer 14

Used for dilution when a client has hypernatremia and cellular dehydration

Question 15

ALERT

What do you want to watch for in clients receiving Hypotonic solutions ?

Answer 15

Want to watch for Cellular edema because the fluid is moving out to the cells, which could lead to fluid volume deficit and decreased blood pressure

Question 16

Hypertonic solutions are packed with what ?

Answer 16

Packed with particles

Question 17

What are Hypertonic solutions ?

Answer 17

Volume expanders that will draw fluid into the vascular space from the cells

Question 18

What are examples of Hypertonic solutions ?

Answer 18

• D10W
• 3% NS
• 5% NS
• D5LR
• D51/2 NS
• D5NS
• TPN
• Albumin

Question 19

TPN, a Hypertonic solution may also be referred to as what ?

Answer 19

PN (parenteral nutrition) or TNA (total nutrient admixture)

Question 20

What are Hypertonic solutions used for ?

Answer 20

• A client with Hyponatremia (were salt goes, water follows)
• Client’s who have shifted large amounts of vascular volume to a 3rd space
• Clients with severe edema, burns, or ascites

Question 21

A Hypertonic solution will do what ?

Answer 21

Return the fluid volume to the vascular space

Question 22

In client’s recieving Hypertonic solutions, what should you watch for ?

Answer 22

Fluid volume excess

Question 23

Where should client’s receiving Hypertonic solutions be monitored ?

With frequent monitoring of what ?

Answer 23

In an ICU setting

Frequent monitoring of blood pressure, pulse, and CVP
(especially if they are receiving 3% NS or 5% NS

Question 24

What are the Joint Commissions top 5 High Alert medications ?

Answer 24

• Insulin
• Opiates and Narcotics
• Injectable potassium chloride or phosphate concentrate
• Intravenous anticoagulants (Heparin)
• Sodium chloride solutions above 0.9 percent

** Double Check these medications with a 2nd Licensed Nurse!**

Question 25

QUICK TIPS FOR IV SOLUTIONS

Isotonic solutions = “ “

Answer 25

“stay where I put them”

Question 26

QUICK TIPS FOR IV SOLUTIONS

Hypotonic solutions = “ “

Answer 26

“go Out of the vessel”

Question 27

QUICK TIPS FOR IV SOLUTIONS

Hypertonic solutions = “ “

Answer 27

“Enter the vessel”