IV Solutions

Question 1

What is the osmolarity of isotonic solutions?

Answer 1

275-295 mOsm/kg

Question 2

What is the osmolarity of hypotonic solutions

Answer 2

< 275 mOsm/kg

Question 3

What is the osmolarity of hypertonic solutions?

Answer 3

> 295 mOsm/kg

Question 4

How do isotonic solutions work in the body?

Answer 4

Isotonic solutions have the same osmolarity of as plasma so no fluid shift occurs

Question 5

What is normal saline 0.9% abbreviation

Answer 5

NS or 0.9 % NaCl

Question 6

What is 0.9% NaCl used for (what does it treat)?

Answer 6

• Helps quickly treat hypovolemia (fast rehydration by increasing circulating plasma volume)
• Hypovolemic shock
• mild hyponatremia

Question 7

Does 0.9 Nacl increase or decrease BP? Once BP is altered by this solution, how does it help the body?

Answer 7

It brings blood pressure up. If blood pressure is low, perfusion is negatively affected. Once BP is increased, tissue perfusion is improved.

Question 8

What are some special considerations for 0.9 NaCl?

Answer 8

• Can cause high Na and Cl levels so not a routine fluid

- avoid with HF pts and and renal pts (decreased renal function) —> FVO risk

Question 9

What solution is safe to use with blood products?

Answer 9

0.9 NS is the only solution safe to use with blood products

Question 10

What type of solution is LR considered?

Answer 10

Isotonic solution

Question 11

What type of solution is 0.9 NaCl considered?

Answer 11

Isotonic solution

Question 12

What are some uses for LR?

Answer 12

Replace fluid loss from/ treat hypovolemia due to:

• Burns
• patients who are NPO preparing for surgery,
• After surgery(maintain hydration and electrolytes levels)
• Vommiting/diarrhea

Question 13

What should we check/monitor when patients are orders LR?

Answer 13

Monitoring electrolytes is essential as LR contains many electrolytes so the patient’s levels can get too high/out of range

Question 14

What does LR have in it?

Answer 14

Na, Cl, K, Ca, and lactate

Question 15

Why is LR not safe to give to patients with liver disease?

Answer 15

Patients who have liver disease cannot metabolize the lactate so lactic acid accumulates in blood, which lowers blood pH ( making it more acidic)

Question 16

Why do we need to check renal function prior to administering LR?

Answer 16

LR contains K+. With kidney damage/impairment, the kidneys struggle to excrete potassium, which can lead to hyperkalemia

Question 17

What type of solution is 0.45 NS (1/2 NS)?

Answer 17

Hypotonic

Question 18

What type of solution is 5% dextrose in water (D5W)?

Answer 18

Hypotonic solution

Question 19

What is 1/2 NS used for?

Answer 19

Hypernatremia. It gradually brings sodium levels down and balances the levels.

Question 20

Why is it important to gradually reduce sodium levels?

Answer 20

We want to avoid bringing it down too quick to avoid pressure changing too quickly

Question 21

What is 5% dextrose(D5W) used to treat?

Answer 21

Hypovolemia (free water allows fluid levels to come back up and increase BP)
Hypernatremia ( free water dilutes sodium, decreasing levels)

Question 22

What are special considerations for 1/2 NS?

Answer 22

Can cause increased ICP and CV collapse from fluid shifting into cells

Question 23

What patient would it be dangerous to give a hypotonic solution to?

Answer 23

Patients with head injuries due to risk of increased ICP

Question 24

What are some risks of D5W?

Answer 24

Hyponateremia (dilutes sodium) 
Increased ICP (fluid shift into cells) 
Water intoxication possible

Question 25

Why should we slowly infuse hypotonic solutions?

Answer 25

FVO risk so slow infusion is safer to prevent chances of FVO

Question 26

What do hypertonic solutions do in body?

Answer 26

Hypertonic solutions are more concentrated than plasma, causing fluid to be sucked out of cells and into IVS

Question 27

What are some types of hypertonic solutions?

Answer 27

5% dextrose with 0.45 NaCl (D5 1/2 NS)
5% dextrose with 0.9 NS (D5 NS) 
10% dextrose (D10W) 
3% NaCl 
(3%NS)

Question 28

How is D5W considered both a hypotonic solution and isotonic solution?

Answer 28

In the IV bag, D5W is isotonic, but once the body metabolizes the sugar, it becomes hypotonic(less concentrated since sugar is gone)

Question 29

What is D5 1/2 NS used for?

Answer 29

Daily maintenance fluid for post op patients to maintain hydration

Question 30

What is a risk of D5 1/2 NS?

Answer 30

Hyperglycemia may occur

Question 31

What is D5 0.9% (D5 NS) used for

Answer 31

Hypovolemia (temporary treatment)

Question 32

Why is D5 NS (D5 0.9% NS) risky? What might it cause?

Answer 32

It can cause both FVO and hyperglycemia

Question 33

What is D10W used for

Answer 33

Base for parenteral nutrition since it has more calories

Hypoglycemia

Question 34

How often do we monitor bg levels with D510W?

Answer 34

Monitor Bg levels Q 6 hrs and PRN since it has a lot of sugar in it

Question 35

Why is D10W ordered for hypoglycemic patients?

Answer 35

Patients who are extremely hypoglycemic, such as prolonged NPO patients or diabetic patients who have had high doses of insulin with inadequate amounts of food to bring blood sugar levels up

Question 36

What is blood osmolarity?

Answer 36

275-295 mOsm/kg

Question 37

What is osmolarity of ECF and ICF?

Answer 37

275-295 mOsm/kg

Question 38

What are signs that someone is experiencing ICP

Answer 38

Lethargy, confusion, coma

Question 39

What is 3%NS used for

Answer 39

Extreme hyponatremia (critical situation)

Question 40

Why would we give 3% NS slowly?

Answer 40

It can decrease chance of FVO and pulmonary edema