Hypertonic Solutions

Published

When have you seen hypertonic solutions given? I think I've only given isotonic and hypotonic.

Thanks

Up Vote Up Vote ×
Specializes in Nurse Tech (Med/Surg, L&D); RN: CCU, ICU.

TPN and PPN (total parenteral nutrition and partial parenteral nutrition) are hypertonic.

Other than that, I know that greater than or equal to 5% Dextrose is considered hypertonic (D5NS, D5LR, D10). Albumin and highly concentrated electrolytes (Potassium, Magnesium), and also blood products, are hypertonic.

Up Vote Up Vote ×

you give hypertonic sol. to Pts with edema or CHF

Up Vote Up Vote ×
Specializes in med/surg, telemetry, IV therapy, mgmt.

here is a list of the hypertonic iv fluids and why they are used. this comes from a previous post, and you can see the other information about the hypotonic and isotonic fluids as well, on this thread: https://allnurses.com/nursing-student-assistance/iv-fluids-need-233712.html - iv fluids...need some help:

  • 5% dextrose and 0.2% sodium chloride (osmolarity of 320, ph of 4.0 to 4.4) - provides calories and water, replaces sodium and chloride. this is given for fluid replacement.
  • 5% dextrose and 0.3% sodium chloride (osmolarity of 365, ph of 4.0 to 4.4) - provides calories and water, replaces sodium and chloride
  • 5% dextrose and 0.45% sodium chloride (osmolarity of 405, ph of 4.0 to 4.4) - provides calories and water, replaces sodium and chloride. this is given for fluid replacement.
  • 5% dextrose and 0.9% sodium chloride (osmolarity of 560, ph of 4.0 to 4.4) - provides calories and water, replaces sodium and chloride. this is given for fluid replacement.
  • 10% dextrose and 0.2% sodium chloride (osmolarity of 575, ph of 4.3) - provides calories and water, replaces sodium and chloride
  • 10% dextrose and 0.45% sodium chloride (osmolarity of 660, ph of 4.3) - provides calories and water, replaces sodium and chloride
  • 10% dextrose and 0.9% sodium chloride (osmolarity of 815, ph of 4.0 to 4.3) - provides calories and water, replaces sodium and chloride
  • 3% sodium chloride (osmolarity of 1030, ph of 5.0) - used to replace severe sodium and chloride losses. other conditions it might be used for are excessive sweating, vomiting, renal impairment and excessive water intake where hyponatremia has occurred.
  • 5% sodium chloride (osmolarity of 1710, ph of 5.0 to 5.8) - used to replace severe sodium and chloride losses. other conditions it might be used for are excessive sweating, vomiting, renal impairment and excessive water intake where hyponatremia has occurred.
  • 10% dextrose and water (osmolarity of 505, ph of 4.3 to 4.5) - provides calories and water
  • 50% dextrose and water (osmolarity of 2526, ph of 4.0 to 4.2) - provides calories and water
  • 5% dextrose in ringer's (osmolarity of 562, ph of 4.3) - provides calories and free water, provides electrolytes. also see the information above with ringer's
  • 5% dextrose in lactated ringer's (osmolarity of 527, ph of 4.9) - provides calories and free water, provides electrolytes. also contains sodium lactate which is used in treating mild to moderate metabolic acidosis. also see the information above with lactated ringers.
  • 5% dextrose and 5% alcohol (osmolarity of 1114, ph of 4.5) - provides calories and free water
  • 5% sodium bicarbonate injection (osmolarity of 1190, ph of 8.0) - is an alkalizing solution that is used to treat metabolic acidosis associated with renal disease and cardiac arrest. the sodium in the solution is an antagonist to the cardiac effects of potassium. it is also used in severe hyperkalemia. it maintains osmotic pressure and acid-base balance. the major complications associated with it's use are related to electrolytes and include metabolic alkalosis, hypocalcemia, hypokalemia, water and sodium retention that cause hypernatremia, other electrolyte imbalances and iv site extravasation that causes chemical cellulitis, necrosis, ulceration and sloughing of the skin.
  • 1/6 m(olar) sodium lactate (osmolarity of 335, ph of 6.5) - contains sodium lactate which is used in treating mild to moderate metabolic acidosis.
  • 10% mannitol injection (osmolarity of 549, ph of 5.7) - mannitol is a sugar alcohol colloid and a plasma expander. it promotes diuresis by drawing fluid from the cells into the plasma. it acts rapidly and is excreted within 3 hours through the kidneys. it is primarily used for intracranial pressure and cerebral edema where it acts within 15 minutes of being infused. it will also be used during the oliguric phase of acute renal failure to promote the excretion of toxic substances from the body. in high intraocular pressure, it pulls fluid from the anterior chamber of the eye within 30 to 60 minutes of infusion. complications include frequent and severe fluid and electrolyte imbalances, cell dehydration, fluid overload, skin extravasation and necrosis with infiltration of the iv site, precipitate formation in the iv line and altered laboratory blood tests. the patient's blood tests should be monitored when the patient is receiving mannitol.
  • 15% mannitol injection (osmolarity of 823, ph of 5.7) - mannitol is a sugar alcohol colloid and a plasma expander. it promotes diuresis by drawing fluid from the cells into the plasma. it acts rapidly and is excreted within 3 hours through the kidneys. it is primarily used for intracranial pressure and cerebral edema where it acts within 15 minutes of being infused. it will also be used during the oliguric phase of acute renal failure to promote the excretion of toxic substances from the body. in high intraocular pressure, it pulls fluid from the anterior chamber of the eye within 30 to 60 minutes of infusion. complications include frequent and severe fluid and electrolyte imbalances, cell dehydration, fluid overload, skin extravasation and necrosis with infiltration of the iv site, precipitate formation in the iv line and altered laboratory blood tests. the patient's blood tests should be monitored when the patient is receiving mannitol.
  • 20% mannitol injection (osmolarity of 1098, ph of 5.7) - mannitol is a sugar alcohol colloid and a plasma expander. it promotes diuresis by drawing fluid from the cells into the plasma. it acts rapidly and is excreted within 3 hours through the kidneys. it is primarily used for intracranial pressure and cerebral edema where it acts within 15 minutes of being infused. it will also be used during the oliguric phase of acute renal failure to promote the excretion of toxic substances from the body. in high intraocular pressure, it pulls fluid from the anterior chamber of the eye within 30 to 60 minutes of infusion. complications include frequent and severe fluid and electrolyte imbalances, cell dehydration, fluid overload, skin extravasation and necrosis with infiltration of the iv site, precipitate formation in the iv line and altered laboratory blood tests. the patient's blood tests should be monitored when the patient is receiving mannitol.

you will also find information about ivs and tonicity of iv fluids on this sticky thread of this forum which you should check out, particularly, post #17: https://allnurses.com/forums/f205/any-good-iv-therapy-nursing-procedure-web-sites-127657.html - any good iv therapy or nursing procedure web sites

you might find these charts useful for clinicals. you can open them up, download and print them out:

Up Vote Up Vote ×

Thank you!:redbeathe

Up Vote Up Vote ×
+ Join the Discussion