Iv Fluids Types

 Intravenous fluids (IV) are  administered to patients to replace fluid, to administer medication and to provide nutrient to the patient when no other route of administration is available . Intravenous fluids is also known as intravenous solutions . Intravenous fluid calculation knowledge is also important for nurse to administer accurate amount of dose.

Purpose of Iv Fluids 

• To provide water, electrolytes and nutrients to meet daily needs 
• To replace water and electrolyte imbalance .
• To administer medications and blood products. 

Types of Iv fluids 

Intravenous fluids or intravenous solutions are catergorized as Isotonic , Hypotonic and Hypertonic according to their osmolality is the same , less than or greater than that of blood.

  Electrolyte solutions are said isotonic when total electrolyte content is app. 310 mEq/L. Hypotonic is considered when total electrolyte content is less than 250 mEq/L and hypertonic when total electrolyte content is grater than 375 mEq/L.

Isotonic solutions

• Isotonic solutions have same osmolality as body fluids
• Increase Extracellular  fluid volume 
• Do not enter the cells because no osmotic force exists to shift the fluids 
• 0.9% NS , 5% dextrose in water (D5W), 5% dextrose in 0.225% saline ( D5W/1/4 NS) and Ringer`s lactate (RL) are some of isotonic solutions.

Sodium chloride (0.9% NS ) Normal saline 

sodium chloride indications  or uses are: 

• Extracellular fluid replacement when cl- loss is equal to greater than Na+ loss.
• 0.9% NS is used in treatment of metabolic acidosis 
• Also used in Na+ depletion
• initiating and terminating blood transfusion 

5% dextrose in water ( D5W )

• D5W provides calories for energy , sparing body protein and preventing ketosis resulting from fat breakdown 
• D5W is used in dehydration , hypernatremia  and drug administraation 
• 3.75 calories are provided per gram of glucose
• D5W  yields 170.6 calories , D5W means 5 gm glucose /100 mL water .
• 50 *3.75 = 187.5 calories /L
• 0.91 * 187.5 = 170.6 calories /L

Ringer`s Lactate RL 

• Composition of RL are 130 mEq/L Na+ , 109 mEq/L Cl- , K+ 4mEq/L , Ca++ 3 mEq/L  , Lactate 28 mEq/L , 9 calories/L 
• Ringers lactate used in vomiting , diarrhea 
• Ringer`s lactate is contraindicated in severe metabolic acidosis or alkalosis and liver disease.

Hypotonic solutions 

• Hypotonic solutions are more dilute solutions and have lower osmolality than body fluids.
• Hypotonic solutions causes movements of water into cells by osmosis
• Should be administered slowly to prevent cellular edema .
• 0.45% NS , 0.225% normal saline(1/2 NS) , 0.33% normal saline ( 1/3 NS ) are some of hypotonic solutions .

0.45% sodium chloride 

0.45% NS  is used for replacement when requirement for Na+ use is questionable

0.225 % Normal saline , 2.5% dextrose in 0.45% saline 

• Used for fluid replacement when some Na+ replacement is necessary
• Encourages diuresis in patients who are dehydrated .

Hypertonic solutions 

• Hypertonic solutions are more concentrated solutions and have higher osmolality than body fluids 
• Hypertonic soltions Causes movements of water from cells into extracellular fluids by osmosis .
• 3% sodium chloride (3%NS), 5% sodium chloride (5% NS), 10% dextrose in water(D10W), 5% dextrose in 0.45 sodium chloride (D5W/1/2 NS ) and 5% dextrose in ringer lactate (D5RL) are some of hypertonic solutions .

10% dextrose in normal saline ( D10NS )

• D10NS is used for nutrition and to replenish Na+ and Cl- 
• Administered in  large veins to dilute and prevent venous trauma.

3% and 5 % Normal saline 

• 3 % and 5% NS is used in water intoxication and severe sodium depletion 
• It is slowly administered to prevent overload ( 100 ml/hour)

Colloid solutions 

• Colloids solutions are also called plasma expanders
• colloids pulls fluid from the interstitial compartment into the vascular compartment .
• colloids are used to increase vascular volume rapidly such as in hemorrhage or in severe hypervolemia .
• Dextran and albumin are colloid solutions .

Iv fluids types  chart