7 - Isotonic, Hypotonic, Hypertonic .pdf

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)