This document describes different types of IV fluids used in medical settings and their indications and nursing responsibilities. It lists isotonic fluids like 0.9% saline and lactated ringer's solution which are used for fluid resuscitation. It describes hypotonic fluids like 0.45% saline and 5% dextrose in water which are used to treat intracellular dehydration and hypernatremia. Hypertonic fluids like 3% saline with dextrose are used to treat severe hyponatremia and cerebral edema. Nurses must closely monitor patients receiving IV fluids for issues like hypovolemia, hypervolemia, and changes in electrolyte levels.

1. TYPES OF IV FLUIDS
IV Fluid Classification/Type Indication Nursing Responsibilities
0.9% Normal Saline
(0.9% NaCl)
Isotonic Fluid resuscitation for hemorrhaging,
severe vomiting, diarrhea, GI
suctioning losses, wound drainage,
mild hyponatremia, or blood
transfusions.
Monitor closely for hypervolemia,
especially with heart failure or renal failure.
Lactated Ringer’s
Solution (LR)
Isotonic
Fluid resuscitation, GI tract fluid
losses, burns, traumas, or metabolic
acidosis. Often used during surgery.
Should not be used if serum pH is greater
than 7.5 because it will worsen alkalosis.
May elevate potassium levels if used with
renal failure.
5% Dextrose in Water
(D5W) *starts as
isotonic and then
changes to hypotonic
when dextrose is
metabolized
Isotonic
Provides free water to help renal
excretion of solutes, hypernatremia,
and some dextrose supplementation.
Should not be used for fluid resuscitation
because after dextrose is metabolized, it
becomes hypotonic and leaves the
intravascular space, causing brain swelling.
Used to dilute plasma electrolyte
concentrations.
0.45% Sodium
Chloride (0.45%
NaCl)
Hypotonic
Used to treat intracellular dehydration
and hypernatremia and to provide
fluid for renal excretion of solutes.
Monitor closely for hypovolemia,
hypotension, or confusion due to fluid
shifting into the intracellular space, which
can be life-threatening. Avoid use in
patients with liver disease, trauma, and
burns to prevent hypovolemia from
worsening. Monitor closely for cerebral
edema

2. 5% Dextrose in Water
(D5W)
Hypotonic
Provides free water to promote renal
excretion of solutes and treat
hypernatremia, as well as some
dextrose supplementation.
Monitor closely for hypovolemia,
hypotension, or confusion due to fluid
shifting out of the intravascular space,
which can be life-threatening. Avoid use in
patients with liver disease, trauma, and
burns to prevent hypovolemia from
worsening. Monitor closely for cerebral
edema.
3% Sodium Chloride
(3% NaCl)
Hypertonic
Used to treat severe hyponatremia and
cerebral edema.
Monitor closely for hypervolemia,
hypernatremia, and associated respiratory
distress. Do not use it with patients
experiencing heart failure, renal failure, or
conditions caused by cellular dehydration
because it will worsen these conditions.
5% Dextrose and
0.45% Sodium
Chloride (D50.45%
NaCl)
Hypertonic
Used to treat severe hyponatremia and
cerebral edema.
Monitor closely for hypervolemia,
hypernatremia, and associated respiratory
distress. Do not use it with patients
experiencing heart failure, renal failure, or
conditions caused by cellular dehydration
because it will worsen these conditions.

3. OR INSTRUMENTS
ALLIS
BABCOCK

4. DEBAKEY
MAYO

5. NORFOLK AND NORWICH/ SELF RETAINING RETRACTOR
NEEDLE HOLDER

6. TOWEL CLIPS
SCALPEL HANDLE

7. METZENBAUM
KELLY CURVE

8. KELLY STRAIGHT
SUCTION AND IRRIGATION INSTRUMENTS

9. RECTAL SPECULUM
TOWEL CLAMP

10. SURGICAL BLADES
SURGICAL MALLET

11. SURGICAL CHISEL
SURGICAL STAPLER

12. KIDNEY BASIN
CAUTERY PEN

13. RING CUTTER
TISSUE FORCEPS

14. CURETTE
DILATOR

15. ADSON FORCEPS