Join NursingCenter to get uninterrupted access to this Article. Among the reasons a patient may receive I. Let's start by reviewing the principles behind fluid and electrolyte balance. The amount of water normally varies somewhat based on such factors as age, sex, and percentage of body fat. The balance is in the extracellular compartment , which consists of:.
Fluid moves between the fluid compartments by osmosis, a process that regulates water and electrolytes so that their distribution and composition in the compartments remain stable.
The rate of osmosis depends on the osmotic pressure within the patient's tissues. This pressure draws water through semipermeable membranes, such as a cell membrane. Responding to osmotic pressure, fluid can move into or out of the cell. The amount of osmotic pressure depends on the ratio between the concentration of ions in the infused solution and the concentration of ions in cell fluid.
Water moves from an area of low ion concentration a hypotonic solution to an area of higher ion concentration a hypertonic solution. When the number of protein molecules in plasma is low, such as in proteinuria seen with uncontrolled diabetes or protein-calorie malnutrition known as kwashiorkor, fluid moves into and stays in the interstitial spaces, where it's unavailable to meet the body's hydration needs.
This is a type of third-space fluid shift , also called third-spacing. This condition sequesters fluid in the interstitial and intracellular spaces and in a third-body space such as the intestinal lumen where it doesn't support circulation.
In addition, it is prefered to give hypertonic solutions via a central line due to the hypertonic solution being vesicant on the veins and the risk of infiltration. Disclosure and Privacy Policy This website provides entertainment value only, not medical advice or nursing protocols.
By accessing any content on this site or its related media channels, you agree never to hold us liable for damages, harm, loss, or misinformation. See our full disclosure and privacy policy. Copyright Notice: Do not copy this site, articles, images, or its contents without permission. Used to dilute plasma electrolyte concentrations. Hypotonic 0. Monitor closely for hypovolemia, hypotension, or confusion due to fluid shifting into the intracellular space, which can be life-threatening.
Avoid use in patients with liver disease, trauma, and burns to prevent hypovolemia from worsening. Monitor closely for cerebral edema. Monitor closely for hypovolemia, hypotension, or confusion due to fluid shifting out of the intravascular space, which can be life-threatening. Nursing, 41 5 , Intravenous fluids with a similar concentration of dissolved particles as blood plasma. Intravenous fluids with a lower concentration of dissolved particles than blood plasma. Intravenous fluids with a higher concentration of dissolved particles than blood plasma.
Proportion of dissolved particles or solutes in a specific volume of fluid. Proportion of dissolved particles in a specific weight of fluid. Previous: Next: We invite you to be part of that discussion. A month-old female is admitted for acute bronchiolitis with increased work of breathing and decreased oral intake. The medical student on the team wonders if a different IV fluid would be selected for a 2-week-old with a similar presentation.
Maintenance IV fluids are continuously infused to preserve extracellular volume and electrolyte balance when fluids cannot be taken orally. In contrast, resuscitation IV fluids are given as a bolus to patients in states of hypoperfusion to restore extracellular volume.
The given IV fluid concentration can be categorized as approximately equal to isotonic or less than hypotonic the plasma sodium concentration. Refer to Table 1 for the electrolyte composition of commonly used IV fluids.
Dextrose is rapidly metabolized upon infusion and does not affect tonicity. A publication by Holliday and Segar laid the foundation for maintenance IV fluid and electrolyte requirements in children and was the initial catalyst for the use of hypotonic maintenance IV fluids.
This claim led to the predominant use of hypotonic maintenance IV fluids in children. By contrast, isotonic IV fluids have been avoided given the apprehension over electrolytes exceeding maintenance needs. Concerns about the unintended consequences of fluid overload — edema, hypernatremia, and hypertension secondary to increased sodium load — have led some to avoid isotonic IV fluids.
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