Types of Dehydration: Hypotonic, Isotonic, and Hypertonic (Nursing)

00:01 So, when we are talking about dehydration, you know, diarrhea, vomiting, fever, all of these things cause dehydration.

00:09 There are a couple of different types of dehydration to be aware of.

00:14 So three main types.

00:17 We're talking hypotonic, isotonic, and hypertonic.

00:22 And you have probably heard these terms before, but just remember that hypotonic, especially when you're thinking about fluid, usually is talking about sodium in levels that is less than what your body would have.

00:38 Isotonic is talking about sodium levels that are the same levels that you would find in your body.

00:45 And hypertonic means sodium levels that are higher than what you would find in your body.

00:51 And that becomes important that concept is important when you think about what types of fluids you're going to use when pediatric patients become dehydrated.

01:02 So when you think about hypotonic dehydration, there are some causes for that.

01:09 Again, you don't have to memorize these, but severe prolonged vomiting, some diarrhea, burns can cause hypotonic.

01:17 The sodium loss is greater than the water loss in these instances.

01:22 And that can really cause some hyponatremia.

01:26 In isotonic dehydration, vomiting and diarrhea can cause this, excessive sweating can cause this, so you're kind of losing sodium and water at the same levels.

01:38 And you just need to read pleat those levels.

01:43 In hypertonic dehydration, excessive sweating can also cause this very poor fluid intake and causes vomiting and causes.

01:52 So notice that the causes can be similar, it's really comes back to how much sodium you're losing.

01:58 But in hypertonic dehydration the sodium loss is less than the water loss.

02:03 So the sodium levels in your body rise, and that gives you hypernatremia.

02:08 Now this becomes important when you think about the types of fluids you're going to be using to fix this dehydration.

02:16 So in hypotonic dehydration, we have a tendency to use normal saline and lactated Ringers.

02:23 You know, even if you've got hyponatremia, you want your fluids to be fairly physiologic meaning isotonic meaning, oh, the sodium levels would be the same as you would expect to find in your body.

02:40 But you're gonna still need to correct that sodium.

02:43 It's a little bit too low.

02:45 So you might add some sodium repletion.

02:48 In addition to those normal saline and lactated ringers.

02:52 In isotonic dehydration, again, you're using normal saline and lactated ringers.

02:58 But notice, you're not going to need to add any extra sodium anywhere because the body already has the amount of sodium that it needs.

03:05 In hypertonic dehydration, I think you're probably sensing a theme here.

03:11 Again, we're using normal saline, we're using lactated ringers, but you also might have to add in some extra water.

03:21 Now we don't use water as IV fluids, but you might have to minimize the amount of sodium.

03:29 So maybe your maintenance fluid is with half normal saline, or a fluid that has a little bit less sodium.

03:36 Or maybe you are able to use the patient's gut and give a little bit of extra water.

03:43 The provider will do all kinds of calculations to figure out how much water we need to give to get that sodium level to come down a little bit.

03:52 So the important thing for you guys to know, is to know that hypertonic dehydration means that there's hypernatremia, that sodium is too high.

04:01 So you can expect there to be some extra water added into the regimen at some point.

04:09 So here is just kind of another way to think about these types of dehydration to kind of help that stick into your brain.

04:16 So you have these normal cells.

04:19 And with hypertonic dehydration, those cells like all of the water just kind of gets sucked right out of them because that sodium is leaving the cells.

04:29 This shows an imbalance of water and sodium in the body.

04:35 And the way that loss of water happens while retaining that high concentration of sodium is where you get your hypertonic dehydration.

04:46 So just different levels of dehydration here.