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Discussion

Trouble with IV Solution, Help?

I know what Isotonic, Hypotonic and Hypertonic do but I have trouble knowing which solution is which!! It drives me nuts. I looked up a lot of resources and they say different things. Like Lactated Ringers is an Isotonic but others say its Hypertonic and the same with D5 0.45% NaCl that its Hypertonic or Hypotonic. Are there any tips to just know which is which without having to memorize all of them? I'm not seeing any similarities or patterns between them. Pleasr I'd appreciate any tips you have.

This has been what I've researched: (Please correct me if I'm wrong)

ISO:

-LR 5% dex in H2O

-0.9% NaCl

HYPOTONIC:

-5% dex H2O

-O.45% NaCl

-0.25% NaCl

HYPERTONIC:

-10-15% dex in H2O

-3% NaCl

-HCO3 5%

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    There are some IV solutions that are isotonic until they get into the blood stream. I.e. D5W - the dextrose gets metabolized when it hits the vascular system and you are left with a hypotonic solution. It is a hypotonic solution for purposes of clinical practice.

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    "Normal" saline (think tears, blood) is 0.9%. If it's 0.9% it's isotonic...think iso=same. Higher concentrations of sodium is hypertonic...hyper=high, so 3%, 5%, 23%. Lower is hypo...hypo=low, for example 0.45%.

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    Isotonic is normal, meaning plain NS 0.9% or plain LR

    Hypertonic had a hyper (high) amount of solutes- anything with dextrose & any saline > 0.9%. Remember na+ & glucose are the main ones responsible for intravascular fluid control.

    Hypotonic is low solutes so less than normal NS 0.33 or 0.45%.

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