Isotonic Solutions by Iris Garcia

Lactated Ringer's (LR)

del_arispe71 — 2016-06-17 13:47:02 UTC

- Also known as Ringer's lactate or Hartmann solution
- First-line fluid resuscitation
- Used to replace GI tract fluid losses, fistula drainage, and fluid losses due to burns or trauma. Given to patients with metabolic acidosis.
- Also for patients experiencing acute blood loss or hypovolemia.
- For electrolyte replacement
- Do not give to patients with liver disease, or lactic acidosis (they can't metabolize lactate)

Nursing Considerations

lariiiiiiii — 2016-06-17 13:47:32 UTC

- Pt.s can quickly develop hypervolemia with rapid fluid infusion
-Monitor for S/S of hyper- and hypovolemia
-Make sure to document baseline VS, edema status, lung and heart sounds BEFORE, DURING, and AFTER
-Assess pt.'s response to IV therapy (monitor S/S of hypervolemia)
-Monitor I/O, Hct, and Hbg

0.9 Sodium Chloride

lariiiiiiii — 2016-06-17 13:49:01 UTC

- also known as normal saline solution. Is used to treat low extracellular fluids (fluid volume deficit) from things such as hemorrhage, severe vomiting, diarrhea, etc.
- conditions treated include shock, mild hyponatremia, metabolic acidosis (DKA), and hypercalcemia
- Use with caution in patients with cardiac/renal disease, because of potential for fluid volume overload.

Signs and Symptoms of Hypovolemia:

lexy_marez — 2016-06-17 13:51:42 UTC

Urine output <0.5mL/kg/hr
Poor skin turgor
Tachycardia
Weak/thready pulse
Hypotension

ISOTONIC SOLUTIONS

del_arispe71 — 2016-06-17 13:53:34 UTC

0.9% NaCl
Lactated Ringer's solution
5% dextrose in water
Ringer's solition

D5W

lariiiiiiii — 2016-06-17 13:58:16 UTC

- provides free water: unbound water molecules small enough to pass through intracellular and extracellular spaces
- D5W can also be considered a hypotonic solution.
- Treats hypernatremia. Aids in renal secretion of solutes.
- CI for resuscitation, post op, and Pts with ICP

Signs and Symptoms of Hypervolemia

irisannette278 — 2016-06-17 13:58:18 UTC

HTN
Bounding pulse
Pulmonary crackles
Dyspnea/ Shortness of breath
JVD
Extra heart sounds

Interventions

irisannette278 — 2016-06-17 14:00:24 UTC

-Elevate the head of the bed 35 to 45 degrees
-Elevate the pt.'s legs if edema is present
-Educate pt. and family about S/S of volume overload and dehydration
-Instruct pt.'s to report trouble breathing and swelling
-Instruct pt. to keep the head of the bed elevated

Ringer's Solution

irisannette278 — 2016-06-17 14:11:33 UTC

- Similar to LR but doesn't contain lactate, so it doesn't have the contraindications related to lactate
- May not be indicated for patients with metabolic acidosis