Intravenous Fluids and Body Responses Flashcards

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Anatomy and Physiology for health professionals
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1

Common hypotonic IV solutions

0.45% Normal Saline (½ NS)

2

Common hypotonic IV solutions

0.33% Normal Saline

3

Common hypotonic IV solutions

0.225% Normal Saline

4

Common hypotonic IV solutions

D5W (acts hypotonic once glucose is metabolized)

5

When do we use hypotonic solutions?

Cellular dehydration

(cells are shriveled → need water)

6

When do we use hypotonic solutions?

Hypernatremia

(high sodium pulls water out of cells → hypotonic fluids push water back in)

7

When do we use hypotonic solutions?

Diabetic ketoacidosis (after initial isotonic fluids)

  • Start with 0.9% NS to stabilize circulation
  • Then switch to 0.45% NS to correct intracellular dehydration

8

Avoid hypotonic fluids in

  • Head injury
  • Stroke
  • Burns
  • Increased ICP

9

Isotonic Solutions

primarily to increase circulating volume

10

common Isotonic IV Solutions

0.9% Normal Saline (NS)

11

common Isotonic IV Solutions

Lactated Ringer’s (LR)

12

common Isotonic IV Solutions

  • D5W (isotonic in the bag only)

⚠️ NCLEX note:
D5W becomes hypotonic once glucose is metabolized.

13

When do we use isotonic solutions?

Indications

  • Hypovolemia
  • Shock
  • Severe dehydration
  • Hemorrhage
  • DKA / HHS (initial fluid)
  • Burns
  • Sepsis

➡️ Think: “Circulation first”

14

Risks & nursing considerations

  • Fluid overload
  • Pulmonary edema
  • Heart failure exacerbation

15

Isotonic fluids expand circulating volume without

causing cell size changes.

16

A hypertonic solution has

MORE solute than blood.

Water moves OUT of the cells and INTO the bloodstream

17

What happens to the cells with hypertonic solutions

  • Water leaves the cells
  • Cells shrink
  • Blood volume increases

18

Common hypertonic IV solutions

3% Normal Saline

19

Common hypertonic IV solutions

5% Normal Saline

20

Common hypertonic IV solutions

D5NS

21

Common hypertonic IV solutions

D5½ NS

22

Common hypertonic IV solutions

D10W

23

What is the goal for hypertonic solutions?

Pull water OUT of cells and INTO circulation

24

When do we use hypertonic solutions?

Severe hyponatremia

25

When do we use hypertonic solutions?

Cerebral edema

26

When do we use hypertonic solutions?

Increased intracranial pressure

27

When do we use hypertonic solutions?

Fluid shifting into tissues (third spacing)

28

Plasma is the

water make-up of your blood

29

Body fluids are distributed between

intracellular fluid(ICF) and extracellular fluid(ECF)

30

intracellular fluid(ICF) lies within body cells and constitutes

two thirds of the total body fluids in adults

31

extracellular fluid(ECF) is made up of

intravascular(plasma), interstitial(fluids that surround the cell), lymph, and transcellular fluids(cerebrospinal, pericardial, pancreatic, pleural, intraocular, biliary, peritoneal, and synovial fluids

32

fluid can move between compartments(through selectively permeable membranes) by a variety of methods which include

diffusion, active transport, filtration, and osmosis in order to maintain homeostasis

33

Isotonic Fluid Volume Deficit (FVD) / Hypovolemia means

34

Common causes of isotonic fluid volume deficit include

Excessive gastrointestinal(GI) loss: vomiting, diarrhea, nasogastric suctioning

35

Common causes of isotonic fluid volume deficit include

Excessive Skin Loss: excessive sweating(diaphoresis), without sodium replacement

36

Common causes of isotonic fluid volume deficit include

Excessive renal system losses: diuretic therapy (water pill), kidney disease, adrenal insufficiency (keeps sodium and water in the body)

37

Common causes of isotonic fluid volume deficit include

burns(swelling somewhere unusual)

38

Common causes of isotonic fluid volume deficit include

Hemorrhage or plasma loss

39

Common causes of isotonic fluid volume deficit include

anorexia, nausea, impaired swallowing, confusion, NPO, decreased intake of water and sodium

40

causes of dehydration

prolonged fever

41

causes of dehydration

Hyperventilation or excessive sweating without water replacement

42

causes of dehydration

diabetic ketoacidosis (A life-threatening complication of diabetes (usually Type 1) caused by not enough insulin.

43

causes of dehydration

insufficient water intake

44

causes of dehydration

diabetes insipidus (A condition where the body can’t concentrate urine because of a problem with ADH (antidiuretic hormone).

45

causes of dehydration

Excess solutes in the urine pull water with them, causing large urine output.

46

causes of dehydration

excessive intake of salt, salt tablets, or hypertonic IV fluids