Concepts II Exam: Isotonic Solutions

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Questions and Answers

What is isotonic?

Equal concentration of solution.

What does an isotonic solution do?

It will cause the extracellular fluid to increase without causing the shift of fluid into or out of the cells, putting the patient at risk for fluid overload.

When would we give an isotonic solution?

Blood loss, dehydration due to vomiting or diarrhea, and during surgery.

What are isotonic solutions? (Select all that apply)

Lactated Ringer's Signup and view all the answers

When should you not give Lactated Ringer's?

If the pH is lower than 7.5 or if the patient has liver disease. Signup and view all the answers

When should you not give 5% dextrose?

To patients with intracranial pressure. Signup and view all the answers

What does a hypotonic solution do?

Hydrates the cell by moving fluid into the cells. Signup and view all the answers

What are hypotonic solutions? (Select all that apply)

0.45% Saline Signup and view all the answers

When do we give hypotonic solution?

Used for patients with dehydration. Signup and view all the answers

Why do we give hypotonic solution?

For patients with diabetic ketoacidosis, hyperosmolarity, and hyperglycemia. Signup and view all the answers

Why do we not give hypotonic solution?

If the patient has had trauma, burns, stroke, increased intracranial pressure. Signup and view all the answers

What is a side effect of hypertonic solution?

Cell rupture. Signup and view all the answers

What does hypertonic solution do?

Moves fluids out of the cells, causing the cell to dehydrate. Signup and view all the answers

What solutions are hypertonic? (Select all that apply)

5% Saline Signup and view all the answers

Where would we usually give hypertonic solution and through what route?

We usually give this in the ICU via central line. Signup and view all the answers

What does hypertonic solution put patients at risk for?

Fluid overload with pulmonary edema. Signup and view all the answers

What does hypertonic solution treat?

Hyponatremia and cerebral edema. Signup and view all the answers

When would you not give hypertonic solution?

To patients with diabetic ketoacidosis and heart/kidney disease. Signup and view all the answers

What does high volume cause?

It causes edema, jugular vein distention, increased blood pressure, and reduced urine output. Signup and view all the answers

What is the treatment for high volume?

Diuretics: expel water and sodium out of the body. Signup and view all the answers

What are nursing interventions for hypervolemia?

Check potassium and sodium levels, monitor I&Os, daily weight, limit fluid and sodium. Signup and view all the answers

What are different sodium restrictions? (Select all that apply)

4g/day Signup and view all the answers

What are sodium normal ranges?

136-145 meq/L. Signup and view all the answers

What are foods high in sodium and low in sodium? (Select all that apply)

Fish and poultry Signup and view all the answers

What is the function of sodium?

Muscle contraction, nerve conduction, and extracellular fluid osmolarity/fluid balance. Signup and view all the answers

Study Notes

Isotonic Solutions

Defined as solutions with equal concentration, preventing fluid shifts into or out of cells.
Common isotonic solutions include 0.9% saline, 5% dextrose in water (D5W), 5% dextrose in 0.225% saline (D5W1/4NS), and Lactated Ringer's.

Clinical Use of Isotonic Solutions

Indicated for managing blood loss, dehydration from vomiting or diarrhea, and post-surgery fluid replacement.
Administering isotonic solutions can lead to fluid overload; monitoring is essential.

Considerations for Lactated Ringer's

Should not be administered if the patient's pH is below 7.5 (indicative of alkalosis) or if the patient has liver disease as it is processed by the liver.

Considerations for 5% Dextrose

Not recommended for patients with increased intracranial pressure, as it becomes hypotonic after metabolism.

Hypotonic Solutions

These solutions, such as 0.45% saline and Dextrose (2.5%) in water, hydrate cells by promoting fluid entry.
Used for conditions like diabetic ketoacidosis, hyperosmolar states, and hyperglycemia.
Contraindicated in patients with trauma, burns, strokes, brain damage, or elevated intracranial pressure due to the risk of cellular edema.

Hypertonic Solutions

Defined as solutions that cause cells to lose water, leading to cellular dehydration.
Examples include 3% saline, 5% saline, and 10% dextrose in water.
Usually administered in an ICU setting via central line, requiring close monitoring.

Risks and Management of Hypertonic Solutions

Risks include fluid overload and pulmonary edema.
Effective for treating hyponatremia and cerebral edema by drawing fluid away from the brain.

Volume Status and Management

High fluid volume can lead to edema, jugular vein distention, increased blood pressure, crackling lung sounds, and reduced urine output.
Treatment includes diuretics (e.g., Laxis) to expel excess water and sodium, noting potassium loss with some diuretics.

Nursing Interventions for Hypervolemia

Routine monitoring of potassium and sodium levels, intake and output, daily weights, and fluid restrictions (typically 2000 ml).

Sodium Recommendations

Sodium levels should typically be 136-145 meq/l.
Dietary restrictions vary: no added salt, 2g/day, and 4g/day options available.
High sodium foods include processed items, while fresh fruits and vegetables are low in sodium.

Function of Sodium

Essential for muscle contraction (skeletal and cardiac), nerve impulse transmission, and maintaining extracellular fluid osmolarity and balance.

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Description

This quiz covers essential concepts related to isotonic solutions, including their definition, effects on extracellular fluid, and indications for use. Understanding when to administer isotonic solutions is crucial for medical professionals. Test your knowledge with these key terms and definitions!