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Types of IV Fluids

This document discusses the four most common types of intravenous (IV) fluids: 1. Normal saline is an isotonic crystalloid solution used for hydration needs like vomiting or diarrhea. 2. Lactated Ringers is similar to blood plasma and used for blood loss, burns, and trauma. 3. Dextrose 5% in water is both isotonic and hypotonic, providing water and electrolytes or diluting concentrations. 4. Half normal saline is a hypotonic solution used to treat hypernatremia or diabetic ketoacidosis. The document also briefly discusses colloid solutions which remain in blood vessels longer than crystalloids.

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503 views6 pages

Types of IV Fluids

This document discusses the four most common types of intravenous (IV) fluids: 1. Normal saline is an isotonic crystalloid solution used for hydration needs like vomiting or diarrhea. 2. Lactated Ringers is similar to blood plasma and used for blood loss, burns, and trauma. 3. Dextrose 5% in water is both isotonic and hypotonic, providing water and electrolytes or diluting concentrations. 4. Half normal saline is a hypotonic solution used to treat hypernatremia or diabetic ketoacidosis. The document also briefly discusses colloid solutions which remain in blood vessels longer than crystalloids.

Uploaded by

harrisburrrg
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Breaking Down IV FluidsThe

4 Most Common Types and


Their Uses
nurse.plus
4 mins read

A
ll nursing programs include fluid balance and intravenous
(IV) therapy as part of the curriculum. The information
about the types of IV solutions and when to use them can be
confusing for a nursing student. Nurse.Plus is happy to offer this
simple reference guide to the four basic types.

When water is lost, IV solutions restore


fluid balance
The human body is made up of about 60% water, with two-thirds of
it stored intracellularly. The rest is found in blood vessels and
between the cells. Water makes up 73% of the brain and heart; 83%
of the lungs; 79% of the muscles and kidneys; and 64% of the skin.

Water is essential to every living cell.


Some of its functions:
• Necessary for cellular metabolism and building materials
• Regulation of internal body temperature, through
respiration and sweating
• Transport of protein and carbohydrates
• Elimination of waste through urine and feces
• Shock absorber for the brain and spinal cord
• Joint lubrication

When fluid is lost for any reason, electrolytes become imbalanced,


body systems are stressed, and cognitive function in the brain is
impaired. Blood becomes concentrated, signaling the kidneys to retain
water. As a result, urine output is decreased. When blood is “thicker,”
the heart has to work harder, causing the pulse to increase in order to
maintain blood pressure. All of these compensatory actions by the
body put an already-compromised patient at risk.

Replacement of fluids intravenously resolves the imbalance and


restores normal body functions. Which IV solution to administer is
related to the reason for the fluid loss.

Crystalloid Solutions: Most Commonly


Used
Crystalloid solutions contain small particles that that pass easily
from the bloodstream to cells and tissues. There are three types of
crystalloids, given according to their tonicity, the ability to make
water move into or out of a cell by osmosis.
Tonicity is related to the concentration of all the solute particles in a
solution, called the osmolarity. A solution with few particles has a low
osmolarity, while a solution with a high number of particles has a
high osmolarity. Water moves through the semipermeable membranes
of the body from low-to-high osmolarity, to create a balance of water
and solutes.

The three types of crystalloids are:

1. Hypotonic: When the extracellular fluid has fewer solutes


(osmolarity) than the fluid in the cells. Water will move
from extracellular space into the cells.
2. Hypertonic: When the extracellular fluid has more solutes
(osmolarity) than within the cells, water flows out of the
cells.
3. Isotonic: Both the extracellular and intracellular fluids have
the same osmolarity, so there is no movement of water
between them.

Which crystalloid solution to administer?


It depends…
Although crystalloids are administered routinely, which solution is
ordered depends on the patient’s condition. Four solutions are the
most commonly administered. Here is a brief description of each:

1. 1

0.9% Normal Saline (NS, 0.9NaCl, or NSS)


Less commonly, this solution is referred to as physiological
saline or isotonic saline

One of the most common IV fluids, it is


administered for most hydration needs:
hemorrhage, vomiting, diarrhea, hemorrhage,
drainage from GI suction, metabolic acidosis, or
shock. It is an isotonic crystalloid that contains 0.9%
sodium chloride (salt) that is dissolved in sterile water. It’s
the fluid of choice for resuscitation efforts as well. It is
sometimes used with caution or even avoided in patients
with cardiac or renal compromise because of the sodium
causing fluid retention or volume overload. IMPORTANT: NS
is also the only fluid used in conjunction with blood product
administration.

2. 2

Lactated Ringers (LR, Ringers Lactate, or RL)

The IV solution most similar to blood plasma


concentration, it is the fluid of choice for burn and
trauma patients. It used for acute blood loss;
hypovolemia from third-space fluid shifts; electrolyte
imbalance; and metabolic acidosis. LR is an isotonic
crystalloid containing sodium chloride, potassium chloride,
calcium chloride, and sodium lactate in sterile water. It is
contraindicated in patients with a pH > 7.5, patients with
liver disease who are unable to metabolize lactate, or for
any patient with lactic acidosis. Use with extreme caution in
cases of renal failure.
Watch the following video if you want to learn more about
administering Lactated Ringers.

3. 3

5% Dextrose in Water (D5 or D5W)

A crystalloid that is both isotonic and hypotonic,


administered for hypernatremia and to provide
free water for the kidneys. Initially hypotonic, D5
dilutes the osmolarity of the extracellular fluid. Once the
cells have absorbed the dextrose, the remaining water and
electrolytes become an isotonic solution. D5 should not be
used as the sole treatment of fluid volume deficit, because it
dilutes plasma electrolyte concentrations. It is
contraindicated in resuscitation, early post-op recovery,
cardiac and renal conditions, and in any case of suspected
increased intracranial pressure. Because the solution
contains calories, due to dextrose (a form of glucose) as the
solute, it does provide very limited nutrition.

Here is a short animation that explains consequences of


fluid overload for tissues.

4. 4
0.45% Normal Saline (Half Normal Saline,
0.45NaCl, .45NS)

A hypotonic crystalloid solution of sodium


chloride dissolved in sterile water, administered to
treat hypernatremia or diabetic ketoacidosis.. It is
contraindicated in patients with burns, trauma, or liver
disease due to depletion of intravascular fluid volumes. Half
normal saline may result in fluid overload and subsequent
decreased electrolyte concentrations or pulmonary edema.
Infusing too quickly can cause hemolysis of red blood cells.

Colloids: Less frequent, but important!


Colloids have large molecules that are unable to pass through
semipermeable membranes. They remain in the blood vessels. They’re
also called volume or plasma expanders, because they draw fluid from
the interstitial space back into the blood vessels with oncotic
pressure. Because colloids require less volume than crystalloid
solutions, they are used for patients who are unable to tolerate large
fluid volumes, or are malnourished.

Some of the uses for colloids are shock, external burns, pancreatitis,
peritonitis, and post-op albumin loss. Common colloids are Albumin
and Hespan.

As a nurse, learn the types of IV solutions, and the reasons they are
administered. Be aware of contraindications, and notify the
prescribing provider if you know any reasons the patient should not
receive fluid replacement with the solution.

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