Isotonic, hypotonic and hypertonic solutions.

Assigned by : Mr. Sultan
Presented by:
Zerish and Maryam Noor
21-Jan-2019 1By Maryam and Zerish

Objectives:
At the end of this this presentation you will be able to:
• Define solution, solvent and solute.
• Define isotonic, hypertonic and hypotonic solutions.
• Define their causes and signs & symptoms.
• Discuss the various types of fluids are administered.
• Discuss the importance of these fluids.
• Identify the osmolarity of various fluids.

Solution
• A solution is a homogeneous mixture of one or
more solutes dissolved in a solvent.
• Solvent: the substance in which a solute
dissolves to produce a homogeneous mixture
• Solute: the substance that dissolves in a solvent
to produce a homogeneous mixture
– Note that the solvent is the substance that is present in
the greatest amount.
21-Jan-2019 By Maryam and Zerish 3

Solution
For example:
A 5% solution of glucose in water.
Glucose is solute and water is solvent.
Solute + Solvent = Solution

Osmolarity
The total number of solute particles per liter.
OR
The total solute concentration.
• Osmolarity is expressed as mOsm/L.
• Osmolarity of blood increases with dehydration and decreases
with overhydration
Result:
Increased water reabsorption, more concentrated urine.

Solutions
There are many situations in which cell membrane becomes turgid,
flaccid or it remains normal.
According to the availability of water the cell has to face three types
of environment.
• Isotonic solution
• Hypotonic solution
• Hypertonic solution
The cell loves to be in an isotonic state and when something
happens to make it unequal (like with hypotonic or hypertonic
conditions) cells becomes abnormal.

Isotonic solution
• Iso: same/equal
• Tonic: concentration of a solution
• An isotonic solution is one in which the
concentration of solutes is same both inside
and outside of the cell.

cont..
Result
• For the cells in your body, the ideal solution
is an isotonic solution.
• Water flowing in balanced with water
flowing out.

Isotonic fluids
• 0.9% Saline
• 5% Dextrose in 0.225% saline
(D5W1/4NS)
• Lactated Ringer’s

Uses
Isotonic solutions are used:
To increase the extracellular fluid volume due to
• Blood loss
• Surgery
• Dehydration
• Fluid loss that has been loss extracellularly

Normal Blood Osmolarity
• The osmolarity of blood is about 300-310 mOsm/L.
• 0.9 NaCl is isotonic with blood serum and that means that it will
diffuse out of the blood vessel after IV injection in a similar
fashion to the components of the blood serum itself.
• 0.9NaCl contains:
– 154 mOsm/L of Na
– 154 mOsm/L of Cl
Giving the solution an osmolarity of 308 mOsm/L.
The American Heart Association recommends no more than 2,300
milligrams (mg) a day=1 teaspoon of salt

Hypotonic solution
• Hypo: “under/beneath”
• A hypotonic solution is one in which the
concentration of solutes is greater inside the
cell than outside of it.
• less solute ; more water (in solution)
• The normal range for blood sodium levels
is 135 to 145 mEq/L

Hypotonic
Result
• Water is transported into the cell.
• A cell placed in hypotonic solution will burst.
Hypotonic fluids
• 0.45% Saline (1/2 NS)
• 0.225% Saline (1/4 NS)
• 0.33% saline (1/3 NS)

Causes
• Hyponatremia or hypotonia occurs when the sodium in your
blood falls below 135 mEq/L.
• Heart diseases
• Kidney failure
• Drinking too much water
• Decreased salt intake.

Signs and symptoms
Hypotonicity causes:
• Nausea and vomiting
• Putting edema
• Headache
• Confusion
• Loss of energy, drowsiness and fatigue
• Muscle weakness, spasms or cramps
• Seizures
• Coma

Uses
Hypotonic solutions are used
• When the cell is dehydrated and fluids need to be put back
intracellular.
• This happens when patients develop diabetic ketoacidosis
(DKA) or hyperosmolar hyperglycemia.

Hypertonic
• Hyper: excessive
• A hypertonic solution is one where the
concentration of solutes is greater outside
the cell than inside it.
• more solute ; less water (in solution).

Causes
• Severe, watery diarrhea vomiting
• Fever
• Certain medications
• Poorly controlled diabetes
• Larger burn areas on the skin
• Kidney disease

Hypertonic cont..
Result
• Water is transported out from the cell.
• A cell placed in hypertonic solution will lose water and shrink.
Hypertonic fluids
• 3% Saline
• 5% Saline
• 10% Dextrose in Water (D10W)
• 5% Dextrose in 0.9% Saline
• 5% Dextrose in 0.45% saline

• Decreased urine out put
• Thirst and dry mouth
• Fluid retention
• Muscle twitching or spasm
• Seizures and coma may occur (in severe)
• Brain dysfunction
Signs and symptoms

Identify these results:

Identify Osmolarity

Patient scenarios
• Your patient has had nausea, vomiting, and diarrhea for 4 days.
The blood work shows this patient is dehydrated but their
electrolytes have managed to stay within normal limits.
• What kind of solution is this patients blood?
– Hypertonic
• What kind of fluid would you give this patient?
– Isotonic at first such as 0.9% NaCl (expand their volume and
give them more to move or shift around)
– Hypotonic second, usually 0.45% NaCl (shift the fluid into the
cells)

Cont..
• Your patient comes in with pitting edema on the lower
extremities. The blood work confirms congestive heart failure
(CHF).
– Hypotonic
– Hypertonic (shifts fluid out of the extracellular space and
into the vein, to be filtered out in the kidneys)

Cont..
• You patient is hypotensive, dizzy, weak, and reports abdominal
pain. The blood work confirms adrenal insufficiency.
– Isotonic
• Adrenal insufficiency leads to loss of volume and loss of
sodium leaving the patient hypovolemic and hyponatremic.
– Isotonic to help treat the hypotension by expanding the volume
of fluid in the veins.

References:
If you want to get further knowledge you may follow these
references:
• https://www.nursingcenter.com/journalarticle?
Article_ID=652137&Journal_ID=54016&Issue_ID=652101
• www.chem.purdue.edu
• https://www.mayoclinic.org/diseases-
conditions/hyponatremia/symptoms-causes/syc-20373711

Exersice:
1.An IV solution contains the electrolyte sodium. Which of the
following statements is true concerning the sodium?
A. The sodium is the solution.
B. The sodium is the solute.
C. The sodium is the solvent.
D. All of the above are true concerning the sodium

Cont..
2. Match the following IV solutions to their description:
• __ Hypertonic a. Concentration the same as the body plasma
• __ Isotonic b. Concentration less than the body plasma
• __Hypotonic c. Concentration greater than the body plasma

Cont..
3.When water and electrolytes lost in equal proportion, so called
a) Isotonic dehydration c) Hypotonic dehydration
b) None of the above d) Hypertonic dehydration
4.When water loss exceeds water loss:
a) Hypotonic dehydration c) Isotonic dehydration
b) Hypertonic dehydration d) All of these

Cont..
5. Which one is not included in symptoms of hypertonia:
a) Decreased urine out put c) Thirst and dry mouth
b) Fluid retention d) Loss of energy
6. Which one of them is hypertonic solution:
a) 3% saline c) 0.9% Normal saline
b) 0.45% saline d) 0.35 saline

Isotonic, hypotonic and hypertonic solutions.

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