IV Solution Cheat Sheet

A quick reference guide on the different intravenous solutions.

Type Use Special Considerations

Normal Saline (NS) Increases circulating plasma Do not use in patients with heart failure,
volume when red cells are edema, or hypernatremia, because NSS
0.9% NaCl in adequate replaces extracellular fluid and can lead to
Water Shock fluid overload.
Crystalloid Fluid replacement in patients Replaces losses without altering fluid
Solution with diabetic ketoacidosis concentrations.
Isotonic (308 Hyponatremia Helpful for Na+ replacement
mOsm) Blood transfusions
Resuscitation
Metabolic Alkalosis
Hypercalcemia
1/2 Normal Saline Water replacement Use cautiously; may cause cardiovascular
(1/2 NS) Raises total fluid volume collapse or increase in intracranial
DKA after initial normal pressure.
0.45% NaCl in saline solution and before Dont use in patients with liver disease,
Water dextrose infusion trauma, or burns.
Crystalloid Hypertonic dehydration Useful for daily maintenance of body fluid,
Solution Sodium and chloride but is of less value for replacement of
Hypotonic (154 depletion NaCl deficit.
mOsm) Gastric fluid loss from Helpful for establishing renal function.
nasogastric suctioning or Fluid replacement for clients who dont
vomiting. need extra glucose (diabetics)
Lactated Ringers Replaces fluid and buffers Has similar electrolyte content with serum
(LR) pH but doesnt contain magnesium.
Hypovolemia due to third- Has potassium therefore dont use to
Normal saline space shifting. patients with renal failure as it can cause
with electrolytes Dehydration hyperkalemia
and buffer Burns Dont use in liver disease because the
Isotonic (275 Lower GI tract fluid loss patient cant metabolize lactate; a
mOsm) Acute blood loss functional liver converts it to bicarbonate;
dont give if patients pH > 75.
Normal saline with K+, Ca++, and lactate
(buffer)
Often seen with surgery
 D5 W Raises total fluid volume. Solution is isotonic initially and becomes
Helpful in rehydrating and hypotonic when dextrose is metabolized.
Dextrose 5% in excretory purposes. Not to be used for resuscitation; can
water Crystalloid Fluid loss and dehydration cause hyperglycemia
solution Hypernatremia Use in caution to patients with renal or
Isotonic (in the cardiac disease, can cause fluid overload
bag) Doesnt provide enough daily calories for
*Physiologically prolonged use; may cause eventual
hypotonic (260 breakdown of protein.
mOsm) Provides 170-200 calories/1,000cc for
energy.
Physiologically hypotonic -the dextrose is
metabolized quickly so that only water
remains - a hypotonic fluid
D5NS Hypotonic dehydration Do not use in patients with cardiac or
Replaces fluid sodium, renal failure because of danger of heart
Dextrose 5% in chloride, and calories. failure and pulmonary edema.
0.9% saline Temporary treatment of Watch for fluid volume overload
Hypertonic (560 circulatory insufficiency and
mOsm) shock if plasma expanders
arent available
SIADH (or use 3% sodium
chloride).
Addisonian crisis
D5 1/2 NS DKA after initial treatment In DKA, use only when glucose falls < 250
with normal saline solution mg/dl
Dextrose 5% in and half-normal saline Most common postoperative fluid
0.45% saline solution prevents Useful for daily maintenance of body
Hypertonic (406 hypoglycemia and cerebral fluids and nutrition, and for rehydration.
mOsm) edema (occurs when serum
osmolality is reduced
rapidly).
D5LR Same as LR plus provides Contraindicated in newborns ( 28 days of
about 180 calories per age), even if separate infusion lines are
Dextrose 5% in 1000ccs. used (risk of fatal ceftriaxone-calcium salt
Lactated Ringers Indicated as a source of precipitation in the neonates
Hypertonic (575 water, electrolytes and bloodstream).
mOsm) calories or as an alkalinizing Contraindicated in patients with a known
agent hypersensitivity to sodium lactate.
Normosol-R Replaces fluid and buffers Not intended to supplant transfusion of
pH whole blood or packed red cells in the
Normosol Indicated for replacement of presence of uncontrolled hemorrhage or
Isotonic (295 acute extracellular fluid severe reductions of red cell volume
mOsm) volume losses in surgery,
trauma, burns or shock.
Used as an adjunct to restore
a decrease in circulatory
volume in patients with
moderate blood loss