IV SOLUTIONS

Hypertonic Solution

A solution with more particles than water that pulls fluid into the bloodstream.

Examples of Hypertonic Solutions

3% Normal Saline, 5% Normal Saline, D5NS, D5½NS.

When to Administer Hypertonic Solutions

Severe hyponatremia, cerebral edema, third-spacing (burns, ascites).

Risks of Hypertonic Solutions

Risk for fluid overload; usually requires a central line and close monitoring.

Hypotonic Solution

A solution with fewer particles than water that causes fluid to move into cells.

Common Hypotonic Fluids

0.25% NaCl, 0.45% NaCl (half normal saline), 2.5% Dextrose.

When to Administer Hypotonic Solutions

Cellular dehydration, hypernatremia, diabetic ketoacidosis (after initial isotonic fluids).

Risks of Hypotonic Solutions

Risk for cerebral edema; avoid in increased ICP, stroke, or trauma.

Isotonic Solutions

Solutions with the same osmolality as plasma that remain in vascular space.

Common Isotonic Solutions

0.9% Normal Saline (NS), Lactated Ringer's (LR), D5W (isotonic in bag, hypotonic in body).

When to Administer Isotonic Solutions

Fluid volume deficit, dehydration, hypovolemia, shock, post-op fluid replacement, initial fluid resuscitation.