http://bit.ly/nrsngacademy This lecture covers fluid balance within the body and specifically discusses hypertonic solutions and their role within nursing.

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HYPERTONIC SOLUTIONS
What, How, and Why?

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TONICITY
● Comparison of osmolarity of 2 solutions
● IV fluid compared to blood plasma
● Less concentrated = Hypotonic
● Similar concentration = Isotonic
● More concentrated = Hypertonic

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HYPERTONIC =
Higher osmolarity than blood

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D5NS or D5LR
EXAMPLES
IV Fluid Solutions that are Hypertonic
1.5%, 3%, or 5% Sodium Chloride
D10W
D5 ½ NS (406 mOsm/L in the bag)

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HYPERTONIC IV SOLUTIONS
● Osmolarity = > 375 mOsm/L
● Fluid shift
○ INTO blood vessels
○ OUT of cells
○ OUT of tissues
● Effect on cells:
○ Shrink

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● Correct sodium SLOWLY
● >3% in Central Line ONLY
● Heart failure / Renal failure
USING HYPOTONIC SOLUTIONS
INDICATIONS CONTRAINDICATIONS
● Hyponatremia
● Cerebral Edema
● Other edema

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KEY POINTS
Hypertonic More solute than blood plasma
Fluid Shifts INTO vessels → OUT of cells and tissues
Examples 1.5%, 3%, 5% NaCl, D5NS/D5LR, D10W
Indications Hyponatremia, Cerebral edema
Contraindications Heart/Renal Failure. 3% CVC, correct Na SLOWLY
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HAPPY
NURSING!!