Nursing Fundamentals: IV Fluids and Deficient Fluid Volume

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Questions and Answers

What is the purpose of infusing isotonic IV solutions in patients with fluid volume deficit?

To raise their blood pressure

What type of IV fluid has a similar concentration of dissolved particles as blood?

Isotonic solution

What is the result of infusing too much isotonic fluid?

Excessive fluid volume or hypervolemia

What type of IV fluid has a lower concentration of dissolved solutes than blood?

Hypotonic solution Signup and view all the answers

What is the effect of infusing hypotonic IV solutions on the blood?

Decreased concentration of dissolved solutes in the blood Signup and view all the answers

What is the significance of osmosis in IV fluid administration?

It affects the movement of fluid between compartments Signup and view all the answers

What is the example of an isotonic IV solution mentioned in the text?

0.9% Normal Saline (0.9% NaCl) Signup and view all the answers

What is the example of a hypotonic IV solution mentioned in the text?

0.45% sodium chloride (0.45% NaCl) Signup and view all the answers

What occurs when hypotonic IV solutions are administered, and how does it affect the concentration of solutes in the bloodstream and within the cell?

Osmotic movement of water from the intravascular compartment into the intracellular space occurs, resulting in a lower concentration of solutes in the bloodstream compared to within the cell. Signup and view all the answers

What is the primary concern when administering hypertonic IV solutions, and how does it affect serum sodium levels?

The primary concern is hypervolemia, and hypertonic solutions with sodium can elevate serum sodium levels, which should be closely monitored. Signup and view all the answers

What is the main difference between isotonic and hypotonic IV solutions, and how do they affect red blood cell size?

Isotonic solutions have the same concentration of solutes as blood, whereas hypotonic solutions have a lower concentration. Isotonic solutions maintain normal red blood cell size, whereas hypotonic solutions cause cells to swell. Signup and view all the answers

What is the primary use of Lactated Ringer's Solution (LR), and what is a contraindication for its use?

The primary use of LR is for fluid resuscitation, GI tract fluid losses, burns, traumas, or metabolic acidosis. It is contraindicated if serum pH is greater than 7.5 because it will worsen alkalosis. Signup and view all the answers

What is the effect of infusing 5% Dextrose in Water (D5W) on the intravascular space, and why is it not used for fluid resuscitation?

Infusing D5W initially provides an isotonic solution, but it becomes hypotonic when dextrose is metabolized, causing fluid to leave the intravascular space and potentially leading to brain swelling. Therefore, it is not used for fluid resuscitation. Signup and view all the answers

What is the primary concern when using 0.45% Sodium Chloride (0.45% NaCl) to treat intracellular dehydration, and what patient population should it be avoided in?

The primary concern is hypovolemia, hypotension, or confusion due to fluid shifting into the intracellular space. It should be avoided in patients with liver disease, trauma, and burns to prevent worsening hypovolemia. Signup and view all the answers

What is the primary use of 0.9% Normal Saline (0.9% NaCl), and what should be monitored closely during its administration?

The primary use of 0.9% NaCl is for fluid resuscitation for hemorrhaging, severe vomiting, diarrhea, GI suctioning losses, wound drainage, mild hyponatremia, or blood transfusions. Hypervolemia should be monitored closely, especially in patients with heart failure or renal failure. Signup and view all the answers

What is the effect of hypertonic IV solutions on the osmotic movement of water, and how does it differ from isotonic and hypotonic solutions?

Hypertonic IV solutions cause the osmotic movement of water out of cells and into the intravascular space to dilute the solutes in the blood. This differs from isotonic solutions, which maintain equal concentrations, and hypotonic solutions, which cause water to move into cells. Signup and view all the answers

What is the effect of infusing isotonic IV solutions on red blood cell size, and how does it differ from the effect of hypertonic and hypotonic solutions?

Isotonic IV solutions maintain normal red blood cell size, whereas hypertonic solutions cause cells to shrink and hypotonic solutions cause cells to swell. Signup and view all the answers

What is the primary concern when administering 3% sodium chloride (3% NaCl) hypertonic IV solution, and how does it affect the concentration of solutes in the intravascular space?

The primary concern is hypervolemia, and the solution causes an increased concentration of dissolved solutes in the intravascular space, leading to osmotic movement of water out of cells and into the bloodstream. Signup and view all the answers

What is the primary purpose of administering 5% Dextrose in Water (D5W)?

To provide free water for renal excretion of solutes and treat hypernatremia. Signup and view all the answers

Identify two critical monitoring requirements for 3% Sodium Chloride (3% NaCl).

Monitor for hypervolemia and hypernatremia. Signup and view all the answers

Why should 5% Dextrose and 0.45% Sodium Chloride not be used in patients with heart failure?

It may worsen their condition by causing hypervolemia. Signup and view all the answers

What additional benefit does Lactated Ringer’s provide when used with 5% Dextrose?

It provides some alkaline action in the blood. Signup and view all the answers

Differentiate between osmolarity and osmolality.

Osmolarity refers to the concentration of dissolved particles in a fluid, while osmolality refers to that concentration in a specific weight of fluid. Signup and view all the answers

What condition is 5% Dextrose in Water particularly contraindicated in?

Patients with liver disease, trauma, and burns. Signup and view all the answers

List one potential life-threatening complication associated with fluid shifts from 5% Dextrose in Water.

Cerebral edema. Signup and view all the answers

For what acute condition is 3% Sodium Chloride primarily used?

Severe hyponatremia. Signup and view all the answers

What should be monitored when administering hypertonic solutions?

Monitor for hypervolemia and respiratory distress. Signup and view all the answers

What is a significant risk of administering hypertonic fluids to patients with cellular dehydration?

It can worsen their condition. Signup and view all the answers

Study Notes

Intravenous Solutions

IV fluids are prescribed to patients who experience deficient fluid volume, restoring fluid to the intravascular compartment and facilitating fluid movement between compartments due to osmosis.
There are three types of IV fluids: isotonic, hypotonic, and hypertonic.

Isotonic Solutions

Isotonic solutions have a similar concentration of dissolved particles as blood.
Example: 0.9% Normal Saline (0.9% NaCl).
When administered, isotonic IV solutions do not cause osmotic movement of fluid between compartments.
Used for patients with fluid volume deficit (hypovolemia) to raise blood pressure.
However, infusion of too much isotonic fluid can cause excessive fluid volume (hypervolemia).

Hypotonic Solutions

Hypotonic solutions have a lower concentration of dissolved solutes than blood.
Example: 0.45% sodium chloride (0.45% NaCl).
When administered, hypotonic IV solutions cause osmotic movement of water from the intravascular compartment into the intracellular space.
Used to treat cellular dehydration.
May cause cerebral edema if too much fluid moves out of the intravascular compartment into cells.
May worsen hypovolemia and hypotension if too much fluid moves out of the intravascular space and into cells.

Hypertonic Solutions

Hypertonic solutions have a higher concentration of dissolved particles than blood.
Example: 3% sodium chloride (3% NaCl).
When administered, hypertonic IV solutions cause osmotic movement of water out of the cells and into the intravascular space.
Used to treat severe hyponatremia and cerebral edema.
May cause hypervolemia, hypernatremia, and associated respiratory distress.

Comparison of IV Solutions

See Table 15.3 for a comparison of types of IV solutions, their uses, and nursing considerations.

Osmolarity and Osmolality

Osmolarity refers to the proportion of dissolved particles in an amount of fluid.
Osmolality refers to the proportion of dissolved particles in a specific weight of fluid.
The terms osmolarity and osmolality are often used interchangeably in clinical practice.

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Description

Learn about intravenous solutions, their purpose in restoring fluid to the intravascular compartment, and their role in treating deficient fluid volume in patients.