Fluid Volume Excess - Labs - ANSWER- Laboratory findings: based on the area of the body
in which the shift occurs.
• Decreased specific gravity of urine (less than 1.010).
, • Decreased hematocrit.
• Decreased serum sodium secondary to dilution.
• Large fluid shifts occur in severe injuries, burns, intestinal perforations and obstruction, and
lymphatic obstruction. (Zerwekh 2013, p. 115)
Isotonic Solutions - ANSWER- Used to expand ECF volume and for intravascular dehydration.
• D5W: 5% dextrose in water (physiologically hypotonic).
• 0.9% NaCl (normal saline solution).
• Lactated Ringer's solution.
May be used to dilute medications or to keep the vein open.
Note: In D₅W the dextrose is metabolized rapidly, leaving free water to be absorbed. It does not
replenish electrolytes; it is contraindicated for clients with head injuries and should be used with
caution in children because of the potential for increase in intracranial pressure. (Zerwekh 2013,
p. 115)
Hypotonic Solutions - ANSWER- • Contain more water and less basic electrolytes.
• 0.45% or half-strength NaCl (normal saline solution).
• May be used to replenish cellular fluid.
• Monitor closely for intravascular fluid loss, hypotension, changes in level of consciousness, and
edema. (Zerwekh 2013, p. 116)
Hypertonic Solutions - ANSWER- • Used to treat situations of hyponatremia and hypovolemia.
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