Intravenous (IV) solutions are used to replace fluids, electrolytes, and nutrients in clients who cannot take them orally. There are different types of IV solutions available, each with its own composition and osmolality. This guide provides a comprehensive overview of IV solutions, their uses, risks, and indications for use.
Last updated: December 4, 2023Intravenous (IV) solutions can be broadly categorized into three types based on their osmolality: isotonic, hypotonic, and hypertonic.
The choice of which IV fluid to use depends on the client’s condition, lab values, fluid and electrolyte balance, and acid-base balance. For example, normal saline may be used in a client with hypovolemia, whereas a hypotonic solution might be appropriate for a client with hypernatremia. A hypertonic solution could be used for a client with cerebral edema.
Osmolality is a measure of the concentration of solutes in a solution. It’s expressed in osmoles per kilogram of solvent (Osm/kg). In clinical settings, osmolality is commonly used to evaluate the body’s water balance and electrolyte homeostasis.
Isotonic solutions have the same osmolality as blood plasma and do not cause any fluid shift. They are used to replace fluids and electrolytes, maintain hydration, and treat hypovolemia.
Examples of isotonic solutions:
| 0.9% normal saline (sodium chloride) | 308 m0sm/L |
| Lactated Ringer solution | 275 m0sm/L |
| 5% dextrose in water (D5W) | 260 m0sm/L |
| Hetastarch | 310 m0sm/L |
| Normosol | 295 m0sm/L |