Type Isotonic

Solution Dextrose 5% in water (D5W)

Isotonic

0.9% sodium chloride (Normal Saline) (NaCl)

Isotonic

Lactated Ringers (LR)

Hypotonic

0.45% sodium chloride (1/2 normal saline) Dextrose 5% in normal saline Dextrose 5% in normal saline

Hypertonic

Hypertonic

Hypertonic

Dextrose 10% in water

Intravenous Fluid Comparison Uses Special Considerations Fluid loss Use cautiously in renal and cardiac patients Dehydration Can cause fluid overload Hypernatremia Shock Can lead to overload Hyponatremia Use with caution in patients with heart failure or edema Blood transfusions Resuscitation Fluid challenges DKA Dehydration Contains potassium, dont use with renal failure patients Burns Dont use with liver disease, cant metabolize lactate Lower GI fluid loss Acute blood loss Hypovolemia due to third spacing Water replacement Use with caution DKA May cause cardiovascular collapse or increased intracranial pressure Gastric fluid loss from NG or vomiting Dont use with liver disease, trauma, or burns Later in DKA Use only when blood sugar falls below 250 mg/dL treatment Temporary treatment Dont use n cardiac or renal patients for shock if plasma expanders arent available Addisons crisis Monitor blood sugar levels Water replacement Conditions where some nutrition with glucose is required