Hypotonic/Isotonic/ Hypertonic: The basics
The cell is divided into two parts: Intracellular and extracellular.
Each part of the cell is comprised of a solution. These solutions can move into and out of the cell depending on the tonicity of the fluids.
Molecules in the cell, such as electrolytes, move from areas of lower concentration to areas of higher concentration⇒ Osmosis.
The cell loves to be in an isotonic state.
Isotonic⇒ The concentrations of fluids in the cell are the same.
- Isotonic solutions are used to increase the cells extracellular volume due to volume losses such as:
- Hemorrhage
- Surgery
- Vomiting
- Diarrhea
Hypotonic ⇒ Fluid goes into the cell and starts to swell.
- Hypotonic solution is used when the cell is dehydrated (ex.⇒ DKA, HHS)
- Using hypotonic solution replaces fluids intracellularly
- Basically, you are trying to put fluid from outside the cell into the cell to rehydrate it.
***REMEMBER***
DO NOT GIVE HYPOTONIC SOLUTIONS TO PATIENTS WITH BURNS, INCREASED ICP, OR THOSE WHO HAVE LOST A LOT OF BLOOD.
These patients are already at risk for fluid depletion, and this could cause them to lose more fluids
Hypertonic⇒ Fluid is escaping from the cell, causing the cell to shrink.
- Hypertonic solution is used to reverse the side effects of fluid volume excess/edema/
Solutions
Hypotonic
|
Isotonic
|
Hypertonic
|
0.45% NaCl (½ NS)
|
0.9% Saline
|
3% NS
|
.225% NS (¼ NS
|
Lactated Ringers
|
5% NS
|
0.33% NS (⅓ NS)
|
(D5W) 5% Dextrose in water**
|
(D10W) 10 % Dextrose in water
|
5% Dextrose in 0.225% Saline (D5W1/4NS)
|
5% Dextrose in 0.9% Saline
| |
5% Dextrose in 0.45% Saline
| ||
5% Dextrose in Lactated Ringers
|
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