What is the primary risk associated with administering too much hypotonic IV fluid?

Administering too much hypotonic IV fluid primarily poses a risk of cerebral edema, which occurs when there is an excessive influx of water into cells, leading to their swelling. Hypotonic fluids, being lower in solute concentration compared to blood plasma, can cause water to move from the vascular compartment into the cells by osmosis.

In the brain, the cells have limited capacity to accommodate excessive swelling. As fluid enters the brain cells, the increase in intracellular volume can lead to increased intracranial pressure and the potential for serious neurological complications, including edema. This is particularly critical because the skull is a rigid structure, and the brain cannot expand, which can result in dangerous pressure on brain tissue.

In contrast, dehydration would typically be related to inadequate fluid administration rather than an excess of hypotonic fluids. Hypernatremia refers to elevated sodium levels, which often occurs with inadequate water intake or loss of water, not from hypotonic fluid administration. Thrombosis, or the formation of blood clots, is more commonly associated with factors such as prolonged immobility or vascular injury rather than excessive hypotonic fluid administration.