Types of IV Solutions
Solution Uses
Isotonic Has same concentration of
solutes as plasma therefore
0.9% NaCl (normal remains in the vascular
saline) compartment, expanding
Lactated Ringer’s (LR) vascular volume.
5% dextrose in water 0.9% NS and LR are
(D5W) crystalloid solutions,  fluid
volume in both intravascular
and interstitial space w/
minimal fluid volume
expansion
Hypotonic Has lesser concentration of
solutes than plasma therefore
0.45% NaCl (½ NS) treats cellular dehydration
0.33% NaCl (1/3 NS) thru fluid shifting out of the
vascular compartment into
cells; promotes elimination by
kidneys.
Hypertonic Has higher concentration of
5% dextrose in normal solutes than plasma,
saline (D5NS) therefore causing fluid to shift
5% dextrose in 0.45% from the cells into the
NaCl (D5½NS) vascular compartment,
5% dextrose in expanding vascular volume
lactated Ringer’s 10% dextrose—stand by
(D5LR) solution for clients receiving
10% dextrose in water TPN
(D10W) 50% dextrose—used for
20% dextrose in water hypoglycemia
(D20W)
50% dextrose in water
(D50W)
Volume Expanders Colliod solutions—contains
Albumin 5% (Albumin- substances that cannot
5, Buminate 5%) diffuse thru capillary walls,
Albumin 25% resulting in  plasma volume
(Albumin-35, and  osmotic pressure
Nursing Implications
Assess for signs of
hypervolemia
Closely monitor pts w/
CHF or HTN
Avoid giving D5W to pt
risk for  ICP, since
dextrose metabolized fast,
it leaves free water acting
like a hypotonic solution
B/C the liver converts
lactate to bicarbonate,
don’t give LR to pt’s blood
pH exceeds 7.5
Do not admin to clients
at risk for third-space fluid
shift, accumulation—for
ex. burn pts, trauma, or
low level of serum protein
levels from malnutrition or
liver dis.
The shift could cause
cardiovas. collapse from
intravascular fluid
depletion and  ICP from
fluid shift to brain cells
therefore avoid giving to
pt at risk for organ failure,
 ICP from CVA, Head
trauma or neuro sx
Do not admin to clients
w/ impaired kidney or
heart function—as the
system can’t handle the
extra fluid
Monitor for signs of
hypervolemia
Greatly expands the
intravascular
compartment, closely
monitor the pt for
circulatory load
Establish baseline V/S,
lung and heart sounds,
and central venous
pressure. Repeat per
agency protocols.
Buminate 25%) causing fluids to move into Administer w/ large-gauge
Dextran 40 (Gentran vascular compartment; used (18-19 gauge) needle.
40) to treat hypovolemic shock Monitor I & O
Hetastarch (Hepsan Monitor for signs of
[HESI]) hypervolemia
Plasma protein
fraction (Plasmanate,
PlasmaPlex,
Plasmatein, Protenate)
Nutrient Contain some form of Useful in preventing
5% dextrose (D5W) carbohydrate (e.g., dextrose, dehydration but doesn’t
5% dextrose in 0.45% glucose, or levulose) and provide wound healing, 
NaCl water. weight, or normal growth in
D5W provides 170 calories children
per liter
Electrolyte Saline and electrolytes restore Monitor F&E
0.9% NaCl vascular volume and replace Monitor ABGs/ Acid-Base
Ringer’s solution electrolytes imbal.
(contains Na, Cl, K, Ca, LR is also an alkalinizing Monitor I&O
and lactate) solution that treats metabolic
5% dextrose in 0.45% acidosis
NaCl 5% dextrose in 0.45 NaCl is an
acidifying solution to treat
metabolic alkalosis