IV FLUID REPLACEMENT THERAPY INTRODUCTION: A. OVERVIEW of intravenou !IV" f#ui$ re%#a&e'ent t(era%) 1.

IV fluid replacement changes the composition of the serum by adding fluids and electrolytes. 2. Consequently, the nurse must administer IV fluid replacement with caution to avoid adverse reaction , which can include : a. luid volume e!cess " V#$. b. luid volume deficit " V%$. c. luid shifts . d. %ecreased or increased electrolyte levels. *. INDICATION+ : 1. &eplacement of abnormal fluid and electrolyte losses , such as may result from surgery , trauma , burns , or gastrointestinal "'I $ bleeding . 2. (aintenance of daily fluid and electrolyte needs "e.g. in situations in which the patient is unable to ta)e in or tolerate oral food and fluid due to 'I disorders , or the patient*s status is nothing by mouth$. +. Correction of fluid disorders. ,. Correction of electrolyte disorders "in con-unction with other therapies. II. TYPE OF +OLUTION: A. I+OTONIC 1. .n isotonic solution has same osmolar concentration, or tonicity, as the plasma. 2. /his means that the proportion of particles to solution infused is the same as that of the serum 0 as result , fluid , dose not shift across the compartments, and the volume of fluid infused distributes equally across the intracellular and e!trcellular spaces. +. Isotonic solutions include : a. 1.23 sodium chloride " 455$ b. 6actated &inger*s solution. 7. 89:;/;4IC : 1. 8ypotonic solution contain a lower osmolar concentration than the serum . 2. /his means that the solution infused is more dilute than the plasma , containing more water than particles +. <hen hypotonic solutions are infused, fluid shifts from the e!tracellular space to intracellular space to maintain equilibrium. ,. /his eventually leads to swelling or =water logging> of the cells, )nown as water into!ication. ?. .s the swelling increases, the cells eventually rupture. @. 8ypotonic solutions include : a. ? 3 de!trose and water "%?<$. b. 1.,? 3 sodium chloride "half saline$. c. 1.++ 3 sodium chloride. C. HYPERTONIC 1. 8ypertonic solutions have a higher concentration of particles in solution compared with the plasma. 2. /o balance the concentration of fluid and particles across fluid compartments, fluid shifts out of the intracellular space into the e!tracellular space , causing cellular shrin)age or dehydration. +. /his cellular dehydration causes disturbances in the way cells function. ,. In addition , the shift of fluid out of the cells causes the e!tracellular compartment to e!pand, which, if e!cessive, can lead to V#. ?. 8ypertonic solution include:

a. b. c. %. 1. 2. +. ,. a. b. c. d. ?.

+3 sodium chloride. :rotein solution. 8yperalimentation solution of 11 3 , ?1 3, and A1 3 de!trose. C;66;I%5 Colloids are fluids that contain solutes a higher molecular weight "e.g. protein$0 this is in contrast to crystalloids, which are electrolyte solution "eg. %?< , lactated &inger*s solution , 1.23 normal saline$. Colloids solutions have significant osmotic activity and are hypertonic. /he presence of colloids in the vascular space pulls fluids from the interstitial and intercellular spaces. /his osmotic activity ma)es colloid solutions useful for : (obiliBing third C spaced fluids. Correcting hypotension #!panding intravascular volume &eplenishing protein depletion "such as occurs with liver and renal disease , starvation ,'I disease, and multisystem organ failure $