Isotonic Solution

a solution having the same osmotic pressure as blood

expand fluid volume without causing a fluid to shift

285 mOsm/L

Osmotic Pressure

The pressure required to prevent solvent from passing through a semipermeable membrane from a region of higher concentration of solute to a region of lower concentration of solute.

Hypotonic Solution

Solution that has higher water potential than the other solution.

Decreases blood volume.

Fluid is pulled into cells.

<275mOsm/L

Tonicity

A measure of the osmotic pressure (as defined by the water potential of the two solutions) of two solutions separated by a semipermeable membrane.

Hypertonic Solution

A solution with a higher salt concentration than in normal cells of the body and the blood.

Causes cells to lose fluid into surrounding spaces.

Pulls fluid out of cells.

Types of Isotonic Solutions

D5W (5% dextrose in water)

Normal Saline (0.9% NaCL)

LR (Lactated Ringers)

Types of Hypotonic Solutions

0.33% NaCL (1/3 strength saline)

0.45% NaCL (1/2 strength saline)

Types of Hypertonic Solutions

5% Dextrose in 0.45% NaCL

(D10W) 10% Dextrose in Water

5% Dextrose in 0.9% NaCL (Normal Saline)

D5W

(5% Dextrose in water)

 Contains: 170 cal/L & 50g of Glucose

Expands intravascular compartment.

Technically isotonic but, becomes hypotonic once in the body and pulls fluid out of the extravascular and into the cells.
DO NOT USE for FVE; does not contain NaCL- fluid wll dilute NaCL in serum.

Can cause Hyponatremic Encephalopathy rapidly.

Normal Saline

(0.9% NaCL)

Isotonic

Used to temporarily expand extracellular compartment r/t circulatory insufficiency, ie. dehydration. Also used to Tx ketoacidosis.

DO NOT USE as maintenance fluid.

LR

(Lactated Ringers)

Roughly Isotonic- contains multiple Electrolytes (does not contain Mg2 or PO)

                       Tx for: Hypovalemia

                                       Burns

                                       Fluid loss as bile/diarrhea

                                       Metabolic Acidosis

1/3(0.33%)Saline

Hypotonic solution; provides Na+, CL-, and free water

Allows kidneys to select and retain needed amounts

Free water helps kidney eliminate solutes

1/2 NS 

(0.45 NaCL- half strength saline)

Hypotonic Solution provides Na+, CL-, and free water

Used to Tx: Hypernatremia (contains less Na+, dilutes plasma sodium without dropping it too fast)

D5-1/2S

(Dextrose 5% in 0.45% NaCL)

Common Hypertonic solution used to Tx hypovolemia

Used as Maintenance fluid.

Fluid gets pulled into the vascular system. You want to monitor patients receiving any hypertonic solutions for fluid overload, particularly if they are being given at a rapid rate of infusion.

D10W

(10% Dextrose in water)

 Hypertonic solution

Used for Peripheral Parenteral Nutrition PPN)

Supplies 340cal/L

Normal Saline

(5% Dextrose in NS)

Hypertonic solution- Replaces nutrients and electrolytes

Can be usd to temporarily Tx hypovalemia if plasma expander is not available