Kieron Caselli

All nursing programs include fluid balance and intravenous (IV) therapy as part of the curriculum. The information about the types of IV solutions and when to use them can be confusing for a nursing student. Nurse.Plus is happy to offer this simple reference guide to the four basic types.

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The human body is made up of about 60% water, with two-thirds of it stored intracellularly. The rest is found in blood vessels and between the cells. Water makes up 73% of the brain and heart; 83% of the lungs; 79% of the muscles and kidneys; and 64% of the skin.

When fluid is lost for any reason, electrolytes become imbalanced, body systems are stressed, and cognitive function in the brain is impaired. Blood becomes concentrated, signaling the kidneys to retain water. As a result, urine output is decreased. When blood is “thicker,” the heart has to work harder, causing the pulse to increase in order to maintain blood pressure. All of these compensatory actions by the body put an already-compromised patient at risk.

Replacement of fluids intravenously resolves the imbalance and restores normal body functions. Which IV solution to administer is related to the reason for the fluid loss.

Crystalloid solutions contain small particles that that pass easily from the bloodstream to cells and tissues. There are three types of crystalloids, given according to their tonicity, the ability to make water move into or out of a cell by osmosis.

Tonicity is related to the concentration of all the solute particles in a solution, called the osmolarity. A solution with few particles has a low osmolarity, while a solution with a high number of particles has a high osmolarity. Water moves through the semipermeable membranes of the body from low-to-high osmolarity, to create a balance of water and solutes.

The three types of crystalloids are:

Although crystalloids are administered routinely, which solution is ordered depends on the patient’s condition. Four solutions are the most commonly administered. Here is a brief description of each:

Colloids have large molecules that are unable to pass through semipermeable membranes. They remain in the blood vessels. They’re also called volume or plasma expanders, because they draw fluid from the interstitial space back into the blood vessels with oncotic pressure. Because colloids require less volume than crystalloid solutions, they are used for patients who are unable to tolerate large fluid volumes, or are malnourished.

Some of the uses for colloids are shock, external burns, pancreatitis, peritonitis, and post-op albumin loss. Common colloids are Albumin and Hespan.

As a nurse, learn the types of IV solutions, and the reasons they are administered. Be aware of contraindications, and notify the prescribing provider if you know any reasons the patient should not receive fluid replacement with the solution.

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Today, it is a monument to California's multi-cultural history, embracing its Native American, Spanish, Mexican and European heritage. Originally built as a self sufficient community by Spanish Padres and Native Americans, the Mission was a center for agriculture, industry, education and religion.

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