sodium and chloride ions Isotonic saline(0.9% sodium chloride) contains only and is used to expand plasma volume and to correct h saline should not sodium levels) or metabolic alkalosis. Because of its sodium content, be used in patients with heart failure or those that have sodium retention due to liver disease. The fluid of choice in these cases is 0.45% saline. Saline solutions may or may not contain dextrose. choice in many disease situa- Lactated Ringer's solution(LRS) is the fluid of tions. LRS is a saline and lactate solution with electrolytes added. LRS contains sodium, potassium, chloride, calcium, and lactate ions. It has a reduced sodium content as compared to 0,9% sodium chloride. The lactate molecule found in LRS broken down in the liver to bicarbonate andis helpful in the treatment of Aci dosis is seen with severe dehydration, because as cellular breakdown occu acid metabolites(such as lactic acid) are released from cells, Normosolt is a solution with less sodium, more potassium, more magnesium less chloride, and no calcium as compared to LRS, It is an all-purpose replacement fluid and has acetate as a buffer, rather than the lactate used in LRS Plasmalyte has less chloride, more magnesium, and no calcium as compared to LRS. Plasmalyte uses acetate as a base that is broken down in skeletal muscle to bi carbonate. Plasmalyte cannot be given SQbecause it is irritating to tissues. Hypotonic crystalloid solutions are fluids with less sodium concentration than fluid; thus, they dilute the extracellular sodium and cause a portion of the fluid to move into the intracellular space. Distribution hypotonic fluid fluid in the vascular space. An example of hypotonic solution is 5% in water is given IV and divides between the intracellular and extracellular fluid compartments. Two-thirds of the fluid goes to intracellular fluid and one-third goes to the extracellular DsW is used to treat hypernatremia, as a carbohydrate source, and as a fluid supplement in patients that cannot tolerate sodium. It should not be given extracellular fluid already in the body will move toward the DsW, creasing fluid depletion and possibly causing shock. Other examples of hypotonic solutions include(0.25% normal saline) and hNS(0.45% saline)