IV Fluids (Isotonic/Hypertonic/Hypotonic)

Isotonic IV solutions: Lactated Ringer's (LR) -Special Considerations:

• Contains potassium, don't use with renal failure patients • Don't use with liver disease (can't metabolize lactate)

Hypotonic IV solutions:

-0.45% sodium chloride (1/2 normal saline)

• Used for treatment of DKA:

-0.9% sodium chloride (Normal Saline) (NaCl) -0.45% sodium chloride (1/2 normal saline) -Dextrose 5% in ½ normal saline

Treatment for shock:

-0.9% sodium chloride (Normal Saline) (NaCl) -Dextrose 5% in normal saline (temporary)

Isotonic IV solutions:

-Dextrose 5% in water (D5W) -0.9% sodium chloride (Normal Saline) (NaCl) -Lactated Ringer's (LR)

Used for dehydration:

-Dextrose 5% in water (D5W) -Lactated Ringer's (LR)

Hypertonic IV solutions:

-Dextrose 5% in ½ normal saline -Dextrose 5% in normal saline -Dextrose 10% in water

• Don't use with liver disease:

-Lactated Ringer's (LR) (can't metabolize lactate) -0.45% sodium chloride (1/2 normal saline)

0.9% sodium chloride (Normal Saline) (NaCl) -Special Considerations:

• Can lead to overload • Use with caution in patients with heart failure or edema

Lactated Ringer's (LR) -Uses:

• Dehydration • Burns • Lower GI fluid loss • Acute blood loss • Hypovolemia due to third spacing

Dextrose 5% in normal saline -Special Considerations:

• Don't use in cardiac or renal patients

Dextrose 5% in water (D5W) -Uses:

• Fluid loss • Dehydration • Hypernatremia

Dextrose 5% in ½ normal saline -Uses:

• Later in DKA treatment

Dextrose 10% in water -Special Considerations:

• Monitor blood sugar levels

0.9% sodium chloride (Normal Saline) (NaCl) -Uses:

• Shock • Hyponatremia • Blood transfusions • Resuscitation • Fluid challenges • DKA

Dextrose 5% in normal saline -Uses:

• Temporary treatment for shock if plasma expanders aren't available • Addison's crisis

Dextrose 5% in water (D5W) -Special Considerations:

• Use cautiously in renal and cardiac patients • Can cause fluid overload

Dextrose 5% in ½ normal saline -Special Considerations:

• Use only when blood sugar falls below 250 mg/dL

0.45% sodium chloride (1/2 normal saline) -Special considerations:

• Use with caution • May cause cardiovascular collapse or increased intracranial pressure • Don't use with liver disease, trauma, or burns

Dextrose 10% in water -Uses:

• Water replacement • Conditions where some nutrition with glucose is required

0.45% sodium chloride (1/2 normal saline) -Uses:

• Water replacement • DKA • Gastric fluid loss from NG or vomiting