Fluid & Electrolyte Basics VII PDF

Summary

This document discusses isotonic, hypotonic, and hypertonic solutions in the context of nursing. It details their effects on fluid balance within the body. The information covers the characteristics of each solution and relevant cautions for their administration.

Full Transcript

Fluid & Electrolyte Basics VII Fundamentals of Nursing Isotonic Solutions Equilibrium or are...

Fluid & Electrolyte Basics VII Fundamentals of Nursing Isotonic Solutions Equilibrium or are Shifts equal in concentration No Fluid ISO-tonic think “I-SO-perfect” H20 These solutions have perfect balance (equilibrium) of solutes both Memory Trick inside & outside the cell, therefore no fluid shifts are made. Human Iso-tonic Solutions blood is isotonic thus very little osmosis occurs, since isotonic solutions I-so-Perfect “I’m so perfect” (no fluid shift) have the same osmolality as body fluids. List of fluids: Caution 0.9% Sodium Chloride (normal saline) IV Normal Saline IV Lactated Ringer’s (0.9% sodium Chloride) (LR) solution Too much isotonic Lactated Ringer’s (LR) Fluid volume overload! (FVO) Uses: NaCl 0.9% LACTATED RINGER’S Monitor: Blood Pressure Hypotension (low blood pressure) Key Manifestation: HTN crisis! Blood transfusions BP over 180/systolic Hemorrhaging (blood loss) DKA (Type 1 diabetic disorder) Risk for CVA stroke HHNS (Type 2 diabetic disorder) Hypotonic Solutions LOwer Osmolarity than body fluids HYPO-tonic think LOW. Memory Trick These solutions have a LOWer osmolarity & LOWer concentration of solutes than body HypO - tonic fluids. They cause the movement of water into cells by osmosis, swelling the cells like a HippO - tonic BIG fat hippo, and therefore should be administered slowly to prevent cellular edema. (cells swell with fluid) Caution List of fluids: 0.45% Sodium Chloride (1/2 NS) Give slowly to prevent: Cellular edema & cerebral swelling 0.225% Sodium Chloride (1/4 NS) HYPO-TONIC HIPPO-TONIC 0.33% Sodium Chloride (1/3 NS) NOT for: 5% Dextrose in 0.225% Saline (D51/4NS) H20 ICP (intracranial pressure) 5% Dextrose in Water (D5W) Memory Trick Manifestation to monitor Cerebral Edema Side Note A lot of numbers D5W! 1. Headache Isotonic in bag A lot of fluid in the cell! 2. Mental Status Changes Hypotonic in body “Altered level of consciousness” New Confusion, Restless, Agitated Used for Cellular Dehydration 3. Seizures & Coma Hypernatremia (Sodium over 145 mEq/L) Hypertonic Solutions HIGHER Osmolarity HYPER- TONIC HYPER PERSON than body fluids HYPER-tonic think HIGH & dry. H20 These solutions have a HIGHER osmolarity & HIGHER concentration of Memory Trick solutes than body fluids. They are very thick salty solutions having HYPER - tonic more solutes & less water, causing water to be moved outside the cells HYPER person and making the cells skinny like a hyper person. (very skinny cells) Caution List of fluids: Give slowly to prevent: 3% Sodium Chloride (3% NS) Used for clients: Cellular dehydration 5% Sodium Chloride (5% NS) Memory Trick Hypovolemia 10% Dextrose in Water (D10W) Fluid volume overload! (FVO) very little numbers Heat related (heat exhaustion) 5% Dextrose in Monitor: Blood Pressure 0.9% Sodium Chloride (D5NS) very little fluid in the cell! Key Manifestation: HTN crisis! Peritonitis 5% Dextrose in BP over 180/systolic 0.45% Sodium Chloride (D51/2NS) Peritoneal Dialysis Risk for CVA stroke 5% dextrose in Lactated Ringer’s (D5LR)

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