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46 notecards = 12 pages (4 cards per page)

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Intravenous Fluids and Body Responses

front 1

Common hypotonic IV solutions

back 1

0.45% Normal Saline (½ NS)

front 2

Common hypotonic IV solutions

back 2

0.33% Normal Saline

front 3

Common hypotonic IV solutions

back 3

0.225% Normal Saline

front 4

Common hypotonic IV solutions

back 4

D5W (acts hypotonic once glucose is metabolized)

front 5

When do we use hypotonic solutions?

back 5

Cellular dehydration

(cells are shriveled → need water)

front 6

When do we use hypotonic solutions?

back 6

Hypernatremia

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

front 7

When do we use hypotonic solutions?

back 7

Diabetic ketoacidosis (after initial isotonic fluids)

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

front 8

Avoid hypotonic fluids in

back 8

  • Head injury
  • Stroke
  • Burns
  • Increased ICP

front 9

Isotonic Solutions

back 9

primarily to increase circulating volume

front 10

common Isotonic IV Solutions

back 10

0.9% Normal Saline (NS)

front 11

common Isotonic IV Solutions

back 11

Lactated Ringer’s (LR)

front 12

common Isotonic IV Solutions

back 12

  • D5W (isotonic in the bag only)

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

front 13

When do we use isotonic solutions?

back 13

Indications

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

➡️ Think: “Circulation first”

front 14

Risks & nursing considerations

back 14

  • Fluid overload
  • Pulmonary edema
  • Heart failure exacerbation

front 15

Isotonic fluids expand circulating volume without

back 15

causing cell size changes.

front 16

A hypertonic solution has

back 16

MORE solute than blood.

Water moves OUT of the cells and INTO the bloodstream

front 17

What happens to the cells with hypertonic solutions

back 17

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

front 18

Common hypertonic IV solutions

back 18

3% Normal Saline

front 19

Common hypertonic IV solutions

back 19

5% Normal Saline

front 20

Common hypertonic IV solutions

back 20

D5NS

front 21

Common hypertonic IV solutions

back 21

D5½ NS

front 22

Common hypertonic IV solutions

back 22

D10W

front 23

What is the goal for hypertonic solutions?

back 23

Pull water OUT of cells and INTO circulation

front 24

When do we use hypertonic solutions?

back 24

Severe hyponatremia

front 25

When do we use hypertonic solutions?

back 25

Cerebral edema

front 26

When do we use hypertonic solutions?

back 26

Increased intracranial pressure

front 27

When do we use hypertonic solutions?

back 27

Fluid shifting into tissues (third spacing)

front 28

Plasma is the

back 28

water make-up of your blood

front 29

Body fluids are distributed between

back 29

intracellular fluid(ICF) and extracellular fluid(ECF)

front 30

intracellular fluid(ICF) lies within body cells and constitutes

back 30

two thirds of the total body fluids in adults

front 31

extracellular fluid(ECF) is made up of

back 31

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

front 32

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

back 32

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

front 33

Isotonic Fluid Volume Deficit (FVD) / Hypovolemia means

back 33

front 34

Common causes of isotonic fluid volume deficit include

back 34

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

front 35

Common causes of isotonic fluid volume deficit include

back 35

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

front 36

Common causes of isotonic fluid volume deficit include

back 36

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

front 37

Common causes of isotonic fluid volume deficit include

back 37

burns(swelling somewhere unusual)

front 38

Common causes of isotonic fluid volume deficit include

back 38

Hemorrhage or plasma loss

front 39

Common causes of isotonic fluid volume deficit include

back 39

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

front 40

causes of dehydration

back 40

prolonged fever

front 41

causes of dehydration

back 41

Hyperventilation or excessive sweating without water replacement

front 42

causes of dehydration

back 42

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

front 43

causes of dehydration

back 43

insufficient water intake

front 44

causes of dehydration

back 44

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

front 45

causes of dehydration

back 45

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

front 46

causes of dehydration

back 46

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