IV Solutions Flashcards
What is the osmolarity of soltions in the human body? Name all 3 with amounts.
- Isotonic: 280-295 mOsm/L in the body and IV solutions.
- Hyptonic: Lower than 250 mOsm/L in the body and IV solutions
- Hypertonic: greater than 295 mOsm/L in the body and IV solutions
What are types of Isotonic Solutions?
Isotonic solutions for fluid maintainence and resusitation for dehydration or remedy of issues such as surgeries.
- 0.9% Normal Saline.
- Lactated Ringers - (contains sodium chloride, sodium lactate, potassoum chloride and calcium chloride in water) Not to be used in hyperkalemia patients because there is potassium chloride in solution; do not use in liver failure patients because there is sodium lactate and the liver cannot break down the lactate; do not use in metabolic alkolosis patients because it counter acts metabolic acidosis by the sodium lactate turning inti bicarb once in the body.
- D5W outside of the body. Once inside the body, it becomes hypotonic because the dextrose is used quickly by the body.
- Collids which are blood products such as fresh frozen plasma, RBCs and Albumin.
What are the indications for using Isotonic Solutions?
- Anything to do with maintaining fluid, ex: NPO.
- From fluid loss like N/V/D/S.
- Dehydration.
- Blood loss such as surgery or trauma.
- Fluid resucutation as in sepsis or trauma injury.
What are contradictions of Isotonic Solutions?
- Metabolic Alkolosis.
- Heart failure patients.
- Hyperkalemia and liver failure patients in lactated ringers.
- And ONLY NS for collids.
What are S&Sx of Isotonic Solutions?
- Bound pulses.
- High BP.
- JVD.
- Lowered SP02 due to ocerload of fluid in tissue so the abilty for the exchange in the aveloris reduce for 02 exhange. And also produces crackles in the lungs.
- Edema.
What are Hypotonic Solutions and types?
Hypotonic solutions brings electrolytes and fluids from the intravascular and extracellular spaces and shifts them into the cell which makes the cell expand.
Anything that is lower in solvent status is deemed hypotonic, ex: 1/3 NS; 1/4 NS.
- 1/3; 1/4; 1/2 (.45%) NS
- D2.5W/ D5W in the body.
- Sterile water.
What are the indications for using Hypotonic Solutions?
- Hypernatermia.
- Cellular Dehydration.
- DKA Diabetes type 2 because it would bring the K+ and insulin inside the cell.
- Diabetes type 1, Hyperosmolar Hyperglycemic Nonketogenic Syndrome aka HHNS.
***Must give slowly to prevent locked in syndrome and cellular edema or ICP.
What are contraindications for Hypotonic Solutions?
- Cerebral Edema/ICP patients
- Burn Victims.
- Hypovolemia patients.
**DO NOT GIVE TO TRAUMA, BURN VICTIMS OR LIVER PATIENTS. CAN CAUSE DEATH!
What are S&Sx to look out for in Hypotonic Solution patients?
- Tachycardia (early sign) then slow pulse.
- High BP.
- Shallow respirations.
- Edema.
- ICP/ CE.
What are Hypertonic Solutions and examples?
Hypertonic solutions are solutions that bring contents from inside the cell and into the intravascular space or extracellular space.
- 1.5%; 3%; 5% NS
- D10W; D50W; D5NS; D5LR
- D5 1/2NS; Used in DKA when blood sugar is brought down.
What are indications for Hypertonic Solutions?
- Cerebral Edema/ ICP patients.
- Hyponatermia.
- Perotenial Dialysis.
- Perotinitis.
What are contraindications for Hypotonic Solutions?
- Correct slowly, given to fast can cause brain damage, locked in syndrome, and seizures.
- Cardiac or renal failture patients.
**USE A CENTRAL LINE FOR 3% OR HIGHER NS ONLY!
What are some S&Sx of Hypertonic Solutions?
Same as Isotonic Solutions
