Help Hypotonic, Isotonic, & Hypertonic Solutions

What is the difference between hypertonic, hypotonic, and isotonic? Nursing Students Student Assist Article

Updated:  

Tonicity refers to the solute concentration of a solution outside a cell and its effect on cellular fluid volume. The osmolarity of the solution determines the direction of water flow into or out of the cell. In normal body situations, solute concentration within and outside of the cell is usually nearly the same (isotonic).

tweetym_22 said:
Can anyone please help me understand the use of these solutions?

Isotonic:

Same osmolarity as the cells (270 - 300 mmol/l). Equal solute and water--exact same number of particles in both solutions--no net movement of water. Does not change cell volume.

Higher solute concentration surrounding cells pulls water out of the cells.

Hypertonic:

Higher osmolarity than cells (> 300 mmol/l). Greater solute, less water--water moves out of cells. The cell will shrink.

Lower solute concentration surrounding cells causes water to move into the cells.

Hypotonic:

Lower osmolarity than cells (< 270 mmol/l). Less solute, more water--water moves into cells. The cell will swell.

Isotonicity:

If the concentrations of electrolytes are the same in the cell and surrounding fluid, the situation is balanced (homeostatic). The cell fluid volume remains the same.

Hypertonicity:

The cell will shrink (crenation) by loss of its fluid to the surrounding hypertonic environment. High osmotic pressure of surrounding fluid pulls fluid out of the cell.

Hypotonicity:

In a hypotonic environment, fluid will enter a cell and cause it to swell and burst. The inside of the cell has higher osmotic pressure than the surrounding fluid, so fluid is drawn into the cell.

Both hypertonicity and hypotonicity in the extracellular fluids will destroy cells.

Need isotonicity for cell homeostasis, for balance.

NS IV is hypotonic relative to cells. Fluid moves from the vascular space into the cells. When a liter of NS is administered intravenously, it will go into the cells and very little will remain in the blood vessel (since it is hypotonic).

If you put two isotonic solutions side by side, no fluid shift occurs. A liter of normal saline or ringer's lactate is limited to the extracellular space and will expand the blood volume.

5% dextrose in NS is hypertonic compared to cells; pulls water into the vascular space from the cells or interstitium.

Hope this explanation helps .

Wow! That is great! Thank you so much!

Also,.could you give a hypertonic solution to someone with cerebral edema, or maybe to reduce edema at a wound site? The D5W solution trips me up sometimes because although it is technically a hypertonic solution its affects are like those of a hypotonic solution. Since the dextrose is is absorbed so quickly you are left with free water that hydrates the cells. My brain is mush!! Thank you again for your help!

Specializes in CNA in nursing home, PCT clinicals.

Daytonite: They're now teaching that a hypotonic solution should NEVER be given to someone with or suspected of having increased or at risk for increased intercranial pressure. (In the notes from the link you gave, it says to "watch patients with increased ICP if given hypotonic solutions" - just wanted to clarify for confused students.

OMG CarVsTree I love you ?

A hypertonic solution can be used to pull water out of the cells and into the extracellular fluid. It can pretty useful in hypovolemia to increase the vascular volume or hyponatremia if symptoms are serious (I.E confusion,seizures) as a result cerebral edema (fluid shifting into brain cells).

A hypotonic solution is given to dilute extracellular fluid and shift water back into the cells via osmosis so that both the ecf and icf compartments can achieve equal expansion or osmolality. It needs to be given cautiously because hypotonic fluids have the potential to cause fluid overload and cellular swelling if overdone.

And isotonic of course only expands the ecf has no effect on the icf and is administered in the case when a patient has both fluid and sodium losses it is also effective in hypovolemic shock to expand vascular fluid volumes. Keeping in mind that excessive administration of isotonic solutions can also cause fluid overload and hypernatremia.

Hope this helps! I know that it may be confusing to get info from different people but hopefully you can draw a little something from each tip that helps this to make just a little more sense.

Specializes in med/surg, telemetry, IV therapy, mgmt.

Confused about something. If a patient has ICP, and we use a hyperosmotic diuretic like Manitol, or a hypertonic solution with saline, I understand that it will pull fluid from the tissue and decrease ICP, but doesn't all that fluid in the vein increase BP as well, which in turn increases ICP again?

Hypotonic solutions will hydrate the cells, pull fluid from the vascular space into the cell.

Isotonic solutions will hydrate the extracellular compartment; replaces fluid vol without disrupting the intracellular and interstial voulumes

Hypertonic Solutions will drae fluid out of intracellular space, leading to increased extracellular volume both in vascular and interstial space.

Specializes in ICU, APHERESIS, IV THERAPY, ONCOLOGY, BC.
Esperanza1 said:
Also,.could you give a hypertonic solution to someone with cerebral edema, or maybe to reduce edema at a wound site? The D5W solution trips me up sometimes because although it is technically a hypertonic solution its affects are like those of a hypotonic solution. Since the dextrose is is absorbed so quickly you are left with free water that hydrates the cells. My brain is mush!! Thank you again for your help!

hypertonic saline is given usually in cases of severe cramps with patient on hemodialysis where cramps occur directly as a result of osmosis and filtration, where sodium chloride levels have been reduced, usually in patientw with fluid overload. Today that is rarer as hemodialysis methods have significantly improved to allow for ultrafiltration (fluid removal) and hemodialysis to lower waste products, ie. BUN ( blood urea nitrogen) and electrolytes especially serum K levels.

Hypertonic Dextrose is applied in acute cases of diabtes where BS levels are controlled by insulin infusion. Specifically, high risk pregnant diabtetic mothers are induced close to term and dext. 10% and insultin infusions are given by iv infusor with Hrly BS measurements.

Isotonic infusions especially in Brain injuries are usually closely monitored and cases of suspected cerebral edema or other ICP's are given low doses of iv. isotonic fluids.

Specializes in MS,Tele,ICU.

Hi,

Can you tell me from a clinical instructors perspective what a day in medical surgical ward constitute with student nurses? I will be teaching for the first time and I will be bringing 10 students to their 2nd Med surg rotation in the hospital. The school does not really give any orientation and so I am on my own. Can you tell me how the day goes in the hospital? I understand that the students will be going to the ward the night before and get their patients and do their nursing care plan to be reported the following day w/ the class . I on the other hand will be meeting the students in the morning, give a little rundown of the plan for the day and send them to their respective wards/units. I will stay with the students in the base ward w/c is med surg and visit the others in the other units . Are the students allowed to give medications? What time do I have them leave so we can discuss the day and they can report their nurse care plan? How do I grade them? I have to read and study the grading system at my place and what criteria you grade. But a little advice from the experts would mean a lot. What do I do with the students that did not do their homework? Some instructors told me they have them leave. Can you tell me some proven techniques to deal with challenges in this area?

Hi need more understanding..if d5% becomes hypotonic or free water as soon as its infused (VickyRN), then why can't we just infuse bottled or mineral water??

WDWpixieRN said:
One question I keep getting confused about is when something is administered in less than 60 minutes...for instance, I saw one question that said administering over 45 minutes...I can figure a 30 minute admin (X 2), but a 15- or 45-minute admin confuses me a bit...any tips for figuring those out?

Hourly rate x 0.75-- 3/4 of hourly rate......3/4 of an hour ?