Hypertonic solutions contain higher concentrations of various dilutes than blood, Isotonic solutions contain the same concentrations, and Hypotonic solutions contain less of its dilute components than blood. As such, you might deliver hypertonic saline to a patient who is electrolytically depleted, an isotonic to a patient whose blood chemistry is good but is hypovolemic, and a hypotonic like D5W to a dehydrated patient whose electrolytes are very high in spite of the dehydration. It's a way of adding fluids and trying to balance the blood chemistry at the same time.
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