Isotonic, Hypotonic, Hypertonic IV Solutions Made Easy | Fluid Electrolytes Nursing Students
Posted On September 17, 2020
a nurse is administering 1 l of 0.9 sodium chloride to a client who is postoperative and has fluid This is a topic that many people are looking for. chibariku.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, chibariku.com would like to introduce to you Isotonic, Hypotonic, Hypertonic IV Solutions Made Easy | Fluid Electrolytes Nursing Students. Following along are instructions in the video below: Everyone is sarah with registered nurse or en comm and in this video. Imm going to be covering isotonic hypotonic and hypertonic solutions. And what i want you get out of this lecture is the following. I want you to know whats happening to this cell when these conditions are presenting. What are the different types of fluids that may be ordered to help a patient whos in these type of conditions and i want to hit on key concepts that you need to know for lecture exams and for the nclex now after this lecture be sure to go to my website register nurse rn calm and take the free quiz that goes along with this lecture. Its going to test you on the solutions. Itll give you scenarios. And youll have to pick. Which options are the correct and you may see some of these questions on a lecture exam. Now the links should be in the description below or a card should be popping up and you can access that okay first lets familiarize ourselves with the cell and how osmosis works because this is the foundation for understanding isotonic hypotonic and hypertonic solution. So lets look at a cell. Okay. Our body is made up of millions of these little things and in the cell. You have the inside of your cell. Which has made up of the organelles you have your electrolyte and its referred to as the intracellular part of the cell. Then surrounding the cell is fluid. And its also made up of electrolyte and its referred to as the extra cellular. So intracellular is the inside remember in intracellular cellular and then extra is outside very important and then you had your solvent and in the solvent. You have solutes and your body loves to have everything equal it wants the same amount on the outside thats on the inside. And if one of these conditions like were going to talk about here in a second happens. The body will use osmosis to correct that and osmosis is where you have less of the concentration trying to move to a higher concentration through a semipermeable membrane. So thats whats happening with osmosis. And i always like to refer to sodium and water sodium and water love each other especially water. Loves sodium and i want to think of it like this i try to always think of little illustrations to help me remember things. And maybe youre like that too i like to think of sodium as the popular kid and water is the kid that wants to be popular and they love hanging out with the popular kid so what happens is that sodium sometimes likes to congregate inside the cell or maybe itll shift and go to the outside. But wherever it goes water wants to go so sodium jumps off a bridge water will jump off a bridge. So try to remember that because that will help you remember the hypotonic and hypertonic whats happening because what will happen is that you will have all this sodium congregated inside of a cell. Now the sodium on the outside of the cell. There wont be as many now. According to the rule of osmosis you will have a shift in fluid from a less concentrated. Which is the outside to a higher concentration. So all that water will want to move in to where sodiums congregating. And it can cause different conditions first lets go over isotonic. Okay isotonic iso means equal iso and then tonic. The second half. The word means concentration of the solution. So there is an equal concentration of the solution on the inside of the cell and on the outside of the cell. The body is happy they love it having it like this now the type of fluids because in the healthcare setting. We will give isotonic fluids so you probably want to write these down because you want to remember them there are four of them and they are on point nine saline. A dextrose five percent in water.
Which is known as d5w and i have an asterisk by that im going to explain that here in a second 5 dextrose in point two to five percent saline and in lactated ringers. Also known as lr now why do i have an asterisk by d5w now d5w whenever you administer it before you administer. It its considered an isotonic solution by after administration. The body quickly metabolizes this dextrose and after the dextrose is gone you just have the water left over so it turns into a hypotonic solution. So you may be reading some literature. And it will talk about its either a hypotonic or isotonic. They use them interchangeably for things. And thats the reason. Why is because your body is absorbing that dextrose and then after it. Absorbs it youre just left over with the other fluid and thats a hypotonic fluid. So keep that in mind now. Why would a patient be ordered an isotonic fluid. They are ordered to increase the extracellular fluid volume. Because whats happened is that the patient has lost this extracellular fluid either through blood loss dehydration with vomiting diarrhea or surgery again probably with the fluid loss. I mean the blood loss. So we give isotonic solutions to increase this they wont cause a shift it wont mess up this cell caused it to shrink or blow up or anything. Like that so we just want to replace the extracellular fluid. And thats how isotonic solutions allow us to do that now lets go onix aleutians hypo means under or beneath. So its low and tonic. Again is just the concentration of the solution. So the concentration of the solution is lower than it should be and ive tried represented in this picture of this cell right here you have this cell and notice. Extracellular lee. You have not a wad of water molecules or your solute. Which is sodium. But on the inside of the cell. You have all this water in all these solutes now. According to osmosis remember this part the extracellular where its less concentrated is going to want to move where its more concentrated. Which is on the inside of the cell. So whats going to happen is youre going to have the shift of all this fluid. Thats extracellular into the cell intracellularly and what will happen is that your cell will swell up and can license mean it can rupture and break apart. So that is whats happening. Whenever you have that side effects again our cell lysis and another thing you have to watch out for whenever you have a patient in this state is that you can deplete the circulatory systems fluid you can make them hypovolemic because whats happening is all this fluid thats in the blood is leaving and entering into the cells. So theyre not going to have any more fluid left so you really have to watch that now in the hospital setting. We like to get patients sometimes hypotonic fluids because they have dehydrated cells. So we will give them this fluid in certain circumstances. Now theres three hypotonic solutions that you need to remember and remember with this because i know it gets confusing. When youre trying to remember what isotonic. Whats hypotonic and whats hypertonic and what helps me remember this is the number of fluids for each hypo. Its low. Its the less of all three and theres only three hypotonic solutions that you really need to.
Remember so and they are. 045 percent of. Saline which is half normal. Saline. 022 of. Saline which is 1. 4. Saline and then 033. Percent. Which is one third saline and those are generally the most popular and again d5w. What we said about with isotonic. It is sometimes used as a hypotonic solution. Because the dextrose is metabolized. Now why are they use and they are used again whenever the cell becomes dehydrated. Because we actually want to move all that fluid into the cell. Because it sells all shrinked up and what what causes the cell to do that diabetic ketoacidosis dka will cause it and hyperosmolar hyperglycemic will also cause that as well so generally if you have a patient who is in these conditions. They will be ordered one of these solutions to help hydrate that cell back now there are instances. Where you do not want to give a hypotonic solution. And this is a popular test question theyll give you a scenario. And they may say a patient comes in with increased intracranial pressure and they are ordered and point. 3 normal saline would you give this and you win. Because you will not give a patient who has increased intracranial pressure hypertonic solution. Because it will shift the fluid into the brain tissue and cause brain swelling. Which is not good and patients who have burns any type of burns and trauma. Because these patients are already hypovolemic and remember this to please your circulatory system you dont want to do that anymore. Now. Lets go over hypertonic. Okay. Hypertonic hyper means excessive and tonic. Again is the concentration of the solution. So you had too much of a concentrated solution going on and lets look at this picture to see whats going to happen now extracellular. If you notice you have a lot of water molecules. And you have a lot of a solid solute and but on the inside of the cell you hardly have anything at all so remember. According to osmosis that fluid will want to shift from a lower concentration. Which is the inside of the cell to a higher concentration. Where everyone else is at so. Whenever that happens youre going to have your cell. Just shrink up. And that is whats happened so side effect is your cell is going to shrink now sometimes we want to cause this to happen. Because the patient has some conditions thats going on now water m.
Hypertonic solutions now to help you remember this there are six of those six of these hypertonic so remember hyper tonic is increased so you have six of those fluids isotonic you just had four of them. And remember how many did you have four hypotonic three. So you have six. And what they are is three percent saline five percent saline 10 dextrose and water. 5 dextrose in point nine percent. Saline. 5. Dextrose in point. And well half normal saline and fibrous dextrose in lr now let me try to go over this to help you remember the fluid types. A little bit pay attention to these percentages. Because hypo looks like a hypo hypo is less notice. These numbers. These are very low percentages of saline so they are on the low end row in but low. Spectrum so you know that theyre hypotonic now normal you have 09. Saline. Thats a normal thats isotonic and then the 5 and then the half with the point to 2 saline that equals isotonic lr is an isotonic then look over here at your hypertonic. You have these higher percentages three percent saline five percent saline. Very very salty so its very concentrated so just try to whenever youre trying to analyze and ask yourself is this a hypertonic hypotonic isotonic fluid make sure youre paying attention to those percentages now these fluids are typically given in the intensive care unit or im unit that can really monitor a patient. Very closely and its given via a central line. Usually because these hypertonic solutions are very very hard on the veins will cause full itis and things like that. And the reason you have to normally give these in the icu is because a patients condition can change very fast if theyre not monitored closely because these fluids cause. Very quickly fluid overload. Which can lead to pulmonary edema. And if you see here. Because whats happening. Remember is that all the fluid is shifting into your vascular system. Because youre just shrinking that cell up so all this is just running through your system. And if you put too much and dehydrate those cells too much youre going to have too much um volume. And its going to back up the hearts not going to be able to handle it its going to back up into the lungs. Youre going to put them in fluid overload. So that is why they have to be watched. Very carefully now why would you give a hypertonic solution now a lot of times. You will have patients who cells. Theyre very swollen and we need to pull all that stuff out of those cells into the body. So the patient can excrete them out and get rid of it and patients with cerebral edema. We like to give that because they because it helps decrease the swelling by removing the fluid off of the brain. So if they have that and you may get like. 3 saline. So that is the prints between isotonic hypotonic and hypotonic solutions now go to my website register nurse orion comm and take the quiz to see how well you know this material and be sure to check my other videos on fluid and electrolytes and thank you so much for watching and please consider subscribing to this youtube channel. .
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