Which intravenous solution is hypertonic?

A hypertonic solution is one that has a higher concentration of solutes compared to the fluid inside cells, leading to the movement of water out of the cells, which can cause them to shrink. In the context of intravenous solutions, dextrose 10% in water (D10W) is considered hypertonic because its higher concentration of dextrose creates an osmotic gradient that can draw water out of cells.

Normal saline (0.9% sodium chloride) is isotonic, meaning it has an equal concentration of solutes compared to blood plasma. 5% dextrose in water starts as an isotonic solution but becomes hypotonic once metabolized because the body utilizes the dextrose, leaving free water. A 0.45% sodium chloride solution is considered hypotonic as it has a lower concentration of solutes compared to blood plasma, which can lead to water moving into cells.

Therefore, dextrose 10% in water is identified as hypertonic due to its ability to raise the osmolarity of the extracellular fluid, drawing water out of the cells and potentially causing cellular dehydration. Understanding the effects of hypertonic solutions is crucial for managing fluid and electrolyte balance in patients receiving intravenous therapy.