Table 15.

3 Comparison of IV Solutions [6]

Type IV Solution Uses Nursing Considerations

Fluid resuscitation for

hemorrhaging, severe vomiting,
diarrhea, GI suctioning losses, Monitor closely for hypervolemia, especially with heart failure
Isotonic 0.9% Normal Saline (0.9% NaCl)
wound drainage, mild or renal failure.
hyponatremia, or blood
transfusions.

Fluid resuscitation, GI tract fluid

Should not be used if serum pH is greater than 7.5 because it
losses, burns, traumas, or
Isotonic Lactated Ringer’s Solution (LR) will worsen alkalosis. May elevate potassium levels if used with
metabolic acidosis. Often used
renal failure.
during surgery.

5% Dextrose in Water (D5W)
*starts as isotonic and then
Isotonic
changes to hypotonic when
dextrose is metabolized
Provides free water to help renal Should not be used for fluid resuscitation because after
excretion of solutes, dextrose is metabolized, it becomes hypotonic and leaves the
hypernatremia, and some intravascular space, causing brain swelling. Used to dilute
dextrose supplementation. plasma electrolyte concentrations.

0.45% Sodium Chloride (0.45% Monitor closely for hypovolemia, hypotension, or confusion due
Hypotonic Used to treat intracellular
NaCl) to fluid shifting into the intracellular space, which can be life-
dehydration and hypernatremia
threatening. Avoid use in patients with liver disease, trauma,
 and to provide fluid for renal and burns to prevent hypovolemia from worsening. Monitor
excretion of solutes. closely for cerebral edema.

Monitor closely for hypovolemia, hypotension, or confusion due

Provides free water to promote
to fluid shifting out of the intravascular space, which can be
renal excretion of solutes and
Hypotonic 5% Dextrose in Water (D5W) life-threatening. Avoid use in patients with liver disease,
treat hypernatremia, as well as
trauma, and burns to prevent hypovolemia from worsening.
some dextrose supplementation.
Monitor closely for cerebral edema.

Monitor closely for hypervolemia, hypernatremia, and

Used to treat severe
associated respiratory distress. Do not use it with patients
Hypertonic 3% Sodium Chloride (3% NaCl) hyponatremia and cerebral
experiencing heart failure, renal failure, or conditions caused by
edema.
cellular dehydration because it will worsen these conditions.

Monitor closely for hypervolemia, hypernatremia, and

5% Dextrose and 0.45% Sodium
Hypertonic
Chloride (D50.45% NaCl)
Used to treat severe
associated respiratory distress. Do not use it with patients
hyponatremia and cerebral
experiencing heart failure, renal failure, or conditions caused by
edema.
cellular dehydration because it will worsen these conditions.

Monitor closely for hypervolemia, hypernatremia, and

5% Dextrose and Lactated Used to treat severe
associated respiratory distress. Do not use it with patients
Hypertonic Ringer’s (D5LR) hyponatremia and cerebral
experiencing heart failure, renal failure, or conditions caused by
edema.
cellular dehydration because it will worsen these conditions.
D10