Colloid IV solutions review for nursing students and nurses!
This review is part of a fluid and electrolyte nursing series. In this series, I cover crystalloid IV fluids, electrolyte imbalances, cell transport, fluid and solute movements, measuring intake and output along with fluid overload and deficit volume disorders.
Don’t forget to review the colloid nursing lecture and take the colloid IV quiz.
Nurse Sarah’s Notes and Merch
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Colloids: What are they?
Colloids are intravenous fluids (given IV) that help increase plasma volume (intravascular space fluid) by “pulling” water into this space through oncotic pressure (colloidal osmotic pressure).
How do Colloids Increase Plasma Volume?
Colloid solutions contain very large molecules that do NOT cross the capillary wall but stay in the intravascular space. The high number (concentration) of these molecules cause an increase in oncotic pressure within the intravascular space, and osmosis occurs.
The result is that water is pulled into the intravascular space from interstitial space. This increases the volume within this compartment.
Lecture on Colloids
Why would Colloid Solutions be Ordered?
If a patient has experienced a loss of fluid volume in the intravascular space or if a patient has experienced a drop in albumin levels (hypoalbuminemia). Therefore, think of any condition that depletes this space or drops albumin levels. For example cases of hypovolemic shock, severe bleeding, and burns.
One thing to mention is about hypoalbuminemia. Albumin is a colloid that resides in the blood plasma naturally. It can’t cross the capillary wall and helps regulate water in the intravascular space by allowing water to be pulled into this space from the interstital space. If levels of albumin drop in the blood plasma, water is no longer pulled into this space but will leave and enter the interstital space. The result is edema.
Types of Colloids
There are two types of colloid solutions that can be ordered: natural and synthetic.
Natural types of colloid solutions include: human albumin, fresh frozen plasma (FFP) and other blood products. Synthetic forms include: hydroxyethyl starches (HES), dextran, and gelatin.
Now you may be wondering what are the differences between colloids and crystalloid solutions:
Colloids:
- Includes Albumin, Dextran, Hydroxyethyl starches (HES), Gelatin, blood products
- Large molecules that say in the intravascular space longer
- They’re fast at expanding the intravascular space and the amount administered typically is equal to the amount of fluid loss.
- Risks: allergic reactions, coagulation problems
- Cost more and harder to access (can’t just go in clean hold and grab them)
Crystalloids:
- Includes Hypotonic, Hypertonic, and Isotonic solutions
- Small molecules that don’t stay too long in the intravascular space
- High amount of these fluids needed to equal the amount of fluid loss (this increases the risk of fluid volume overload)
- No allergic reactions or coagulation problems
- Cost less and easier to access
Nurse’s Role with Colloid Administration
- Assess allergies and check for any past reactions to colloids.
- Watch for gelatin allergy
- Monitor blood pressure, heart rate, oxygen saturation, respiratory rate, temperature during administration per protocol
- Monitor for allergic reaction: itching, hypotension, dyspnea, fever, etc.
- STOP infusion, notify doctor
- Monitor for bleeding problems: increased PTT & PT level, low platelet count, hypotension, tachycardia
- Monitor fluid status: daily weights, strict I’s and O’s, no crackles, edema, s3 gallop
References:
Dengue Clinical Case Management E-learning. (2023). Crystalloid & Colloid IV Solutions: Intravenous Fluids. Retrieved from https://www.cdc.gov/dengue/training/cme/ccm/page70749.html.
Lewis SR, Pritchard MW, Evans DJ, Butler AR, Alderson P, Smith AF, Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill people. Cochrane Database Syst Rev. 2018 Aug 3;8(8):CD000567. doi: 10.1002/14651858.CD000567.pub7. PMID: 30073665; PMCID: PMC6513027.
III, J. L. L. (2023, April 18). Volume overload – endocrine and metabolic disorders. Merck Manuals Professional Edition. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/fluid-metabolism/volume-overload