Type Isotonic

Solution Dextrose 5% in water (D5W)

Isotonic

0.9% sodium chloride (Normal Saline) (NaCl)

Isotonic

Lactated Ringer’s (LR)

• • • • • • • • • • • • • • • • • • •

Hypotonic

0.45% sodium chloride (1/2 normal saline) Dextrose 5% in ½ 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, don’t use with renal failure patients Burns • Don’t use with liver disease, can’t 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 • Don’t use with liver disease, trauma, or burns Later in DKA • Use only when blood sugar falls below 250 mg/dL treatment Temporary treatment • Don’t use n cardiac or renal patients for shock if plasma expanders aren’t available Addison’s crisis • Monitor blood sugar levels Water replacement Conditions where some nutrition with glucose is required

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