MATERNAL SKILLS MIDTERM
REVIEWER # 2
LOREL FAITH G. TORADA
ADMINISTERING IV FLUIDS
What are IV Fluids?
-Intravenous fluids, also known as intravenous
solutions, are supplemental fluids used in intravenous
therapy to restore or maintain normal fluid volume and
electrolyte balance when the oral route is not possible.
 PINK- DEXTROSE 5% LACTATED RINGERS (D5LR)
 BARK BLUE – LACTATED RINGERS’S SOLUTION
 LIGHT BLUE- 5% DEXTROSE IN 0.3% SODIUM CHLORIDE
(DEXTROSE 5% IN NORMAL SALINE) D5NS
 GREEN- 0.9% SODIUM CHLORIDE (NORMAL SALINE
SOLUTION, NSS)
Intravenous (IV) therapy - is therapy that delivers fluids
directly into a vein.
Indications of IV therapy:
1.Maintain hydration and/or correct dehydration in
patient unable to tolerate sufficient volumes of oral
fluids or medications
2.Parenteral nutrition
3.Administration of drugs
4.Transfusion of blood or blood components.
TYPES OF IV FLUIDS
Crystalloids
 are IV solutions containing small molecules that flow
easily across semipermeable membranes
• they are categorized according to their relative
tonicity in relation to plasma.
THREE TYPES:
1.Isotonic – solutions have the same
concentration of solutes as
blood plasma
2.Hypotonic – solutions have lesser
concentration of solutes than
plasma
3.Hypertonic – solutions have greater
concentration of solutes
than plasma
ISOTONIC IV FLUIDS
0.9 na cl (normal saline solution, nss)
⦿ equally expand both intracellular and
extracellular fluid spaces
⦿ have a total osmolality close to that of the
ECF and do not cause red blood cells to shrink
or swell
sodium (154mEq/L) and chloride
(154mEq/L).
⦿ Used in the administration of blood
products
⦿ Used to replace large volume losses such
as in burn injuries and trauma
⦿ Should not be used for clients with heart
failure, pulmonary edema and renal
impairment or condition that cause sodium
retention as it may risk fluid volume overload
ISOTONIC IV FLUIDS
Dextrose 5% in water
⦿ Is initially an isotonic solution with a serum
osmolality of 252mOsm/L
⦿ Provides free water when dextrose is
metabolized (making it a hypotonic solution)
expanding the ECF and the ICF
⦿ Is administered to supply water and to
correct an increase in osmolality
⦿ Not to be used for fluid replacement
because hyperglycemia may result
⦿ Should be avoided to be used in clients at
risk for increased intracranial pressure as it
may cause cerebral edema
 MATERNAL SKILLS MIDTERM
REVIEWER # 2
LOREL FAITH G. TORADA

⦿ have a lower osmolality and contain fewer

solutes than plasma
ISOTONIC IV FLUIDS ⦿
Lactated Ringer’s 5% in Water ⦿ cause fluid shifts from the ECF into the ICF
Used to correct dehydration, sodium depletion and to achieve homeostasis, therefore, causing
replace GI losses cells to swell and may even rupture.

⦿ Can also be used to fluid losses due to burns, fistula ⦿ are usually used to provide free water for
drainage and trauma excretion of body wastes, treat cellular
dehydration and replace the cellular fluid
⦿ the choice for first-line fluid resuscitation for certain
patients HYPOTONIC IV FLUIDS
0.45% Sodium Chloride (0.45% NaCl, ½ NS )
⦿ Often administered to patients with metabolic
acidosis ⦿ also known as half-strength normal saline

⦿ Is metabolized in the liver, which converts the lactate
to bicarbonate, therefore, it should not be given to
patients who cannot metabolize lactate (eg. liver
disease, lactic acidosis)
⦿ Should be used with caution in patients with heart
failure and renal failure
ISOTONIC IV FLUIDS
⦿
Ringer’s Solution Has
content similar to Lactated Ringer’s solution but does
not contain lactate
⦿ Indications are the same with Lactated Ringer’s but
without the contraindications related to lactate
Nursing Considerations for Isotonic Solutions
Elevate the head of the bed at 35 to 45 degrees.
Unless contraindicated, position the client in semi-
Fowler’s position.
Elevate the patient’s legs.
If edema is present, elevate the legs of the patient to
promote venous return.
Educate patients and families.
Recognize signs and symptoms of fluid volume
overload, instruct patients to notify the nurse if they
have trouble breathing or notice any swelling.
Close monitoring for patients with heart failure.
Carefully monitor for signs of fluid overload.
⦿ is a hypotonic IV solution used for replacing
water in patients who have hypovolemia with
hypernatremia
⦿ are used to treat hypernatremia and other
hyperosmolar conditions
HYPOTONIC IV FLUIDS
0.33% Sodium Chloride Solution
⦿ Is used to allow kidneys to retain the needed
amounts of water and is typically administered
with dextrose to increase tonicity
⦿ It should be used in caution for patients
with heart failure and renal insufficiency.
HYPOTONIC IV FLUIDS
2.5% dextrose in water (D2.5W)
⦿ This solution is used to treat dehydration and
decrease the levels of sodium and potassium
⦿ should not be administered with blood
products as it can cause hemolysis of red blood
cells.
Nursing Considerations for HYPOTONIC
Solutions
⦿ Monitor for manifestations of fluid volume
deficit. Signs and symptoms include confusion
in older adults. Instruct patients to inform the
nurse if they feel dizzy.

Warning on excessive infusion. Can lead to

intravascular fluid depletion, decreased blood pressure,
cellular edema, and cell damage.
HYPOTONIC IV FLUIDS
 MATERNAL SKILLS MIDTERM
REVIEWER # 2
LOREL FAITH G. TORADA

⦿ Do not administer along with blood products. Can

cause hemolysis of red blood cells especially during HYPERTONIC IV FLUIDS
rapid infusion of the solution. Dextrose 50% in Water (D50W)

⦿ Monitor for manifestations of fluid volume deficit. ⦿ Is used to treat hypoglycemia and is
Signs and symptoms include confusion in older adults. administered rapidly via IV bolus.
Instruct patients to inform the nurse if they feel dizzy. CLASSIFIED ACCORDING TO THEIR PURPOSE

⦿ Warning on excessive infusion. Can lead to

intravascular fluid depletion, decreased blood TYPES OF IV FLUIDS
pressure, cellular edema, and cell damage. ⦿ Alkalinizing solutions
Are administered to treat metabolic
⦿ Do not administer along with blood products. Can acidosis Examples: LRS
cause hemolysis of red blood cells especially during
rapid infusion of the solution. ⦿ Acidifying solutions
Are used to counteract metabolic alkalosis
HYPERTONIC IV FLUIDS Examples: D51/2NS, 0.9 NaCl

⦿ Volume expanders
⦿ causes cells to shrink and may disrupt their function Are solutions used to increase the blood
volume after a severe blood loss, or loss of
⦿ They are also known as volume expanders as they plasma. Examples: Dextran, Human albumin,
draw water out of the intracellular space, increasing and Plasma
extracellular fluid volume
TYPES:
HYPERTONIC IV FLUIDS COLLOIDS
Hypertonic Sodium Chloride IV Fluids ▪contain large molecules that do not pass
through semipermeable membranes.
⦿ contain a higher concentration of sodium and ▪are IV fluids that contain solutes of high
chloride than normally contained in plasma. molecular weight, technically, they are
hypertonic solutions, which when infused,
⦿ are used in the acute treatment of sodium exert an osmotic pull of fluids from interstitial
deficiency (severe hyponatremia) and should be used and extracellular spaces.
only in critical situations to treat hyponatremia. ▪They are useful for expanding the
intravascular volume and raising blood
pressure.
HYPERTONIC IV FLUIDS ▪They are indicated for patients in
Hypertonic Dextrose Solutions malnourished states and patients who cannot
tolerate large infusions of fluid.
⦿ Hypertonic dextrose solutions are used to provide
kilocalories for the patient in the short term. 1. Human albumin
▪ is a solution derived from plasma
HYPERTONIC IV FLUIDS 2. Dextrans
Dextrose 10% in Water (D10W) ⦿ are polysaccharides that act as colloids

⦿ It should be administered using a central line if 3. Etherified Starch

possible and should not be infused using the same line ⦿are derived from starch and are used to
as blood products as it can cause RBC hemolysis. increase intravascular fluid but can interfere
with normal coagulation
⦿Examples include EloHAES, HyperHAES, and
Voluven.

HYPERTONIC IV FLUIDS
⦿ an osmotic diuretic that causes fluid shifts Dextrose 20% in Water (D20W)
between various compartments to promote 4.Gelatin
diuresis
 MATERNAL SKILLS MIDTERM
REVIEWER # 2
LOREL FAITH G. TORADA

▪ have lower molecular weight than dextrans and

therefore remain in the circulation for a shorter period PARTS OF AN IV CANNULA
of time. 5. Plasma Protein Fraction (PPF)
▪ is a solution that is also prepared from plasma, and
like albumin, is heated before infusion
▪ is recommended to infuse slowly to increase
circulating volume

IV COMPUTATIONS

Drop factors for IV tubing

⦿ macro drop
10 gtt/ml
15 gtt/ml
20 gtt/ml

⦿ micro drop
60 mgtt/ml

Formula for IV Computations

ASSISTING IN IV INSERTION
EQUIPMENTS

PARTS OF IV TUBING