What’s in my IV fluid?
What’s in my IV fluid?
With IV therapy being an extremely common part of medical care, each patient is likely to receive different types of IV fluid. In fact, up to 90 percent of hospitalized patients receive an IV.
Each patient’s IV fluid is selected based on their specific treatment plan.
Because of the wide variety of IV solutions, patients may not fully understand what they are receiving through their IV.
Still, it’s important to ask questions to your care team.

1. Isotonic
2. Hypotonic
3. Hypertonic
READ: Need to read up on your IV terminology? Check out our glossary. Isotonic IV Fluids Isotonic IV fluids are used to increase fluid volume due to blood loss, surgery, or dehydration . There are many different types of common isotonic fluids, such as: 1. Normal Saline (0.9% NaCl, NS) 2. 5% Dextrose in Water (D5W) 3. Lactated Ringer’s Solution (LR) MORE: Read on the 5 Reasons You Might Need an IV.Hypotonic IV Fluids

Hypotonic IV fluids are designed to bring fluid from the bloodstream into the cells and tissues to help in body waste excretion. In other words, they are commonly used to help patients avoid dehydration.
There are many common types of hypotonic fluid, such as:
– 0.45% Normal Saline (Half Normal Saline)
– 0.225% Normal Saline (Quarter Normal Saline)
– 2.5% Dextrose
MORE: Read on Techniques to Prepare and Care for an IV.
Hypertonic IV Fluids
Hypertonic IV fluids are used to shift fluids into the bloodstream to dilute electrolytes. Some of these fluids often appear on the list of vesicants. More on those in a moment.
These types of fluids usually contain dextrose, a simple sugar made from corn, that can be used at higher rates to treat diabetics going through severe hypoglycemia.
However, the use of these fluids must be monitored closely because they could lead to an overload in fluid.
Types of common hypertonic fluids include:
1. Saline Solutions: >0.9%
a. 3% NaCl
b. 5% NaCl
2. Dextrose Solutions >=10%
a. D10W
b. D20W
c. D50W
3. Dextrose 5% in 0.9 Normal Saline (N5NS)
4. Dextrose 5% in 0.45% Normal Saline (D5 1/2 NS)
5. Dextrose 5% in Lactated Ringer’s (D5LR)
Be aware of vesicants
A vesicant is a type of drug that can cause tissue blistering. When that drug leaks due to an infiltration, that is what is known as an extravasation.
Those types of injuries can be severe, leading to tissue death.
Healthcare professionals note that the primary way of reducing extravasation risk is to identify upfront what medications are associated with tissue damage.
We have previously identified two lists – a red list and a yellow list – of vesicant drugs that can cause tissue damage.
Medications such as antibiotics, vitamins, electrolytes, insulin are frequently added to IV solutions that can also make them vesicants.
MORE: Read on the Causes, Signs, Side Effects, and Treatments for IV Infiltrations and Extravasations.
Many people may not even know what medication or fluid they are receiving in their peripheral IV. Potential additives in your IV may include potassium, sodium, dextrose, and others.
Whatever the reason you may find yourself in the hospital, always ask questions when it comes to treatment. Advocating for yourself is a key to success!
References
1Nursing Center – IV Fluids: https://www.nursingcenter.com/getattachment/Clinical-Resources/nursing-pocket-cards/IV-Fluids/IV-Fluids-_January-2019.pdf.aspx#:~:text=Isotonic%20solutions%20have%20a%20concentration,)%20spaces%2C%20increasing%20intravascular%20volume
2 Nurse.Plus – Breaking Down IV Fluids: The 4 Common Types and Their Uses
3Isotonic, Hypotonic, and Hypertonic Solutions: https://uniontestprep.com/hesi-exam/blog/isotonic-hypotonic-and-hypertonic-solutions