Understanding IV Fluids

Introduction

• Presenter: Nicole Weaver, educator with NRSNG
• Background: 10 years experience in critical care and emergency medicine
• Goal: Demystify IV solutions, understand the right solution for patients

Key Concept: Osmosis

• Osmosis: Movement of water across a semi-permeable membrane along a concentration gradient
  • Moves from high water concentration to low water concentration
  • Involves movement of water/fluids

Types of IV Fluid Solutions

1. Isotonic Solutions

   • Definition: Matches blood plasma concentration
   • Purpose: Adds fluid to bloodstream without causing fluid shifts
   • Examples:
     • NS (Normal Saline): 0.9% sodium chloride
     • LR (Lactated Ringers): Contains electrolytes like potassium, magnesium, lactate
   • Usage:
     • LR: Used in surgical/trauma patients (e.g., blood loss)
     • NS: Used in medical patients (e.g., dehydration)

2. Hypotonic Solutions

   • Definition: More dilute than blood plasma
   • Purpose: Causes water to enter cells, making them swell
   • Examples:
     • D5W (Dextrose 5% in Water)
     • 0.45% Saline (Half Normal Saline)
   • Usage:
     • Treats cellular dehydration (e.g., DKA, HHNS)
     • Helps restore cellular hydration

3. Hypertonic Solutions

   • Definition: More concentrated than blood plasma
   • Purpose: Pulls water out of cells, causing them to shrink
   • Examples:
     • 3% Saline
   • Usage:
     • Treats swollen cells (e.g., cerebral edema)

Considerations

• Aim: Restore balance/homeostasis, not to shrink or swell cells
• Monitor patient response to prevent overshoot (over-swelling/shrinking)
• Be an advocate: Question orders that seem incorrect based on fluid knowledge

Memory Aids

• Hypo = Hippo: Big, swollen cells
• Hyper = Hyperactive: Cells getting skinny

Additional Resources

• IV fluid solutions cheat sheet: Osmolarity, tonicity, usage
• Visit NRSNG.com for more lessons on fluid solutions and care

Conclusion

• Understanding osmosis and normal conditions helps in determining patient needs
• NRSNG is a resource to assist through nursing school challenges
• Encouragement: "Happy nursing!"