Which of the following statement(s) is/are true concerning parenternal electrolyte solutions?

b. Glucose is added to hypotonic saline solutions to increase their tonicity

c. About 1/2 of all exogenously administered albumin ends up in the extravascular space

d. Normal saline solution provides excessive sodium and chloride which may lead to body sodium overload

A number of electrolytes solutions are available for parenteral administration. Lactated Ringer’s solution is a physiologic solution containing many of the electrolytes found in plasma. The disadvantage of this solution is the relatively low sodium content (130 mEq/L) as compared to plasma. Hyponatremia can occur with extended use of lactated Ringer’s solution. Isotonic saline (0.9% or normal saline) contains 154 mEq of both sodium and chloride. The excess of both sodium and chloride can lead to electrolyte and acid-base disturbances. Infusion of large volumes of 0.9% saline can lead to total body sodium overload and hyperchloremia. The less-concentrated saline solutions are hypo-osmotic and have excess free water. In addition, 0.2% saline solution is hypotonic with respect to plasma and can result in red blood cell lysis if rapidly infused. For this reason, 5% dextrose is added to these solutions to increase the tonicity. Plasma expanders are commonly used in surgical patients. Plasma protein solutions such as 5% and 25% albumin act initially by increasing plasma oncotic pressures. Abnormalities in microvascular permeability such as those found in the pulmonary circulation in adult respiratory distress syndrome, in regional circulatory bed burns or infections, and in the systemic circulation in sepsis, may result in extravasation of these proteins into the interstitial space. About half of all exogenously administered albumin eventually ends up in the extravascular space. The half life of exogenously administered albumin is about 11 days.