IV Fluid Therapy

What type of solution is the first line choice for fluid resuscitation?

crystalloids

• contain water-soluble electrolytes

What is a hypotonic solution?

contains less e- than the plasma

What is a hypertonic solution?

contains more e- than plasma

What is an isotonic solution?

contains the same amount of e- as the plasma

What is diffusion?

the movement of things from a region of higher concentration to a region of lower

What is the direction of osmotic water movement in an isotonic, hypotonic, and hypertonic solution?

What is the purpose of an isotonic solution?

increase ECF volume d/t

replaces plasma volume, does not cause shifts

What are risks of an isotonic solution?

fluid volume overload

What are three examples of an isotonic solution?

lactated ringers (LR)

normal saline (NS)

D5W

What are common uses of an isotonic solution?

blood loss

surgery

dehydration

fluid loss that has been loss extracellularly

What is the difference between LR and NS?

LR matches our plasma makeup better and contains more types of e-

• caution for other imbalances

NS has more Na

Describe the shift of water in cells caused by HYPOtonic crystalloids.

shifts water from ECF to ICF compartment → out of the blood into the cells and tissue spaces

ICF ← ECF

What are common uses for HYPOtonic crystalloids?

DKA

hypernatremia

What are risks for HYPOtonic crystalloids?

hemolysis

Describe the shift in cells caused by HYERtonic crystalloids.

increases extracellular volume and decreases intracellular volume → out of the cells and into blood

ICF → ECF

What are common uses for HYPERtonic crystalloids?

increased ICP

hyponatremia

What are risks for HYPERtonic crystalloids?

hypervolemia

What are colloid solutions?

contain large insoluble molecules, generally proteins

How do colloid solutions function?

these large molecules do not easily cross the capillary wall, colloids remain in the intravascular space longer than crystalloids, so less volume is needed for the same effect, reducing the risk for fluid overload

What is the benefit of colloids?

can have volume replacement w/ less volume

What is a risk of colloid solutions?

allergic reactions (similar to a blood product)

What are IV therapy complications?

circulatory overload

pulmonary edema

increased ICP

electrolyte/glucose disturbance

important to have the correct IV solution to minimize complications