Hypertonic Flashcards
(16 cards)
What are hypertonic IV solutions?
Hypertonic IV solutions have a greater concentration of solutes (375 mEq/L and greater) than plasma, causing fluids to move out of the cells and into the ECF, which may disrupt cell function.
What is the effect of hypertonic IV solutions on cells?
They cause cells to shrink as fluids move out, potentially disrupting their function.
What are hypertonic sodium chloride IV fluids?
Hypertonic sodium chloride solutions contain a higher concentration of sodium and chloride than plasma, shifting fluids from the intracellular space into the intravascular and interstitial spaces.
What are the strengths of hypertonic sodium chloride IV solutions?
3% sodium chloride (3% NaCl) contains 513 mEq/L of sodium and chloride with an osmolality of 1030 mOsm/L; 5% sodium chloride (5% NaCl) contains 855 mEq/L of sodium and chloride with an osmolality of 1710 mOsm/L.
What are the uses of hypertonic sodium chloride solutions?
They are used in the acute treatment of sodium deficiency (severe hyponatremia) and should be infused at a very low rate to avoid overload and pulmonary edema.
What precautions should be taken when administering hypertonic sodium chloride solutions?
Administer cautiously, usually when serum osmolality is critically low, and some patients may need diuretic therapy to assist in fluid excretion.
What are hypertonic dextrose solutions used for?
They provide kilocalories for the patient in the short term.
What is Dextrose 10% in Water (D10W)?
D10W is a hypertonic IV solution used in the treatment of ketosis of starvation, providing calories (380 kcal/L), free water, and no electrolytes.
What is Dextrose 20% in Water (D20W)?
D20W is a hypertonic IV solution that acts as an osmotic diuretic, promoting fluid shifts between compartments to promote diuresis.
What is Dextrose 50% in Water (D50W)?
D50W is a hypertonic IV solution commonly used to treat severe hypoglycemia and is administered rapidly via IV bolus.
What are the nursing considerations for administering hypertonic IV fluids?
Document baseline data, watch for signs of hypervolemia, monitor the patient during administration, verify orders, assess health history, prevent fluid overload, do not administer peripherally, and monitor blood glucose closely.
What signs should nurses look for to detect hypervolemia?
Signs include swelling in arms, legs, face, shortness of breath, high blood pressure, and discomfort (e.g., headache, cramping).
Why should hypertonic solutions not be administered peripherally?
They can cause irritation and damage to blood vessels and should be administered through a central vascular access device.
What should be monitored closely when infusing hypertonic dextrose solutions?
Blood glucose levels should be monitored closely, as rapid infusion can cause hyperglycemia.
What is a hypertonic solution?
Definition: A solution with a high concentration of solute.
##Footnote
Osmotic Effect: When there is a high concentration in the blood vessels and a low concentration in the cell, water moves from the cell to the blood vessels. This causes the cell to shrink and leads to cellular dehydration.
Examples of hypertonic solution
3% Saline
5% Saline
10% Dextrose in Water (D10W) 5% Dextrose in 0.9% Saline
5% Dextrose in 0.45% saline
5% Dextrose in Lactated Ringer’s
