A client is hypotensive secondary to hypovolemia resulting from dehydration. Based on the nurse's knowledge about intravenous solutions, the nurse would expect the physician to prescribe which type of solution?
A) Isotonic
B) Hypotonic
C) Hypertonic
D) Volume expander
Ans: A
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Isotonic fluids have an osmolarity of 250 to 375 mOsm per liter, which is the same osmotic pressure as that found within the cell. Isotonic fluids are used to expand the intravascular compartment and thus increase circulating volume. Because these solutions do not alter serum osmolarity, interstitial and intracellular compartments remain unchanged (Smeltzer, Bare, Hinkle, & Cheever, 2010). An isotonic solution is helpful for hypotension caused by hypovolemia in dehydration. When a hypotonic solution is infused, it lowers serum osmolarity, causing body fluids to shift out of the blood vessels and into the cells and interstitial space. For this reason, hypotonic fluids are administered when a client needs cellular hydration. Hypertonic fluids have an osmolarity of 375 mOsm per liter or higher and a greater osmotic pressure than the cell. When a hypertonic solution is infused, serum osmolarity is increased, pulling fluid from the cells and the interstitial tissues into the vascular space. The primary use for these solutions are management of intracranial hypertension and shock. Volume expanders, such as albumin, a plasma protein contained within the plasma, is used to restore intravascular volume and to maintain cardiac output in clients with hypoproteinemia.
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