5% dextrose in 1/2 NS? - page 2

by hotshot12345

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I don't understand this. I know of 5DW and 1/2 NS but combining them together? Would this be isotonic, hyper/hypotonic? Can somebody help me figure this out? thanks... Read More


  1. 3
    Quote from sewnew
    Interesting...If that is the case, would D5W 1/2 NS still be contraindicated in a dehydrated patient?
    D5.45NS is a common solution for maintenance and rehydration. Little dextrose for the calories and the .45NS will push fluid back into the cells and help lower the Na levels.

    There is a system to how this all works.

    First you give NS or LR to temporarily correct the fluid volume loss and reestablish sufficient circulation.

    Then you give D5.45NS to rehydrate and push fluids from the veins into the cells, all the while giving some much needed calories.

    Think of D5.45NS as Koolaid or a sports drink. Lots of free water with a bit of sugar for energy.
    kywoodrd, on eagles wings, and sewnew like this.
  2. 3
    Quote from hotshot12345
    I don't understand this. I know of 5DW and 1/2 NS but combining them together? Would this be isotonic, hyper/hypotonic? Can somebody help me figure this out?

    thanks
    It's hypertonic in the bag. Hypotonic in the bloodstream, since RBC's metabolize the 5% dextrose quickly, leaving behind the 0.45% saline which has an osmolality of about 155 mOsm/L
  3. 0
    There is no such fluid as D5W/0.45NS. You either have D5W (5% dextrose is water) or you have D5 0.45ND (5% dextrose in half normal saline). You cannot have 5% dextrose in both water at saline at the same time.
  4. 1
    there is d5.9%, d5.2% and d5.45%. half-normal saline (0.45% nacl), often with "d5" (5% dextrose), contains 77 meq/l of na and cl and 50 g/l glucose.
    quarter-normal saline (0.22% nacl) has 39 meq/l of na and cl and always contains 5% dextrose for osmolality reasons


    table of commonly used iv solutions.doc
    chart of commonly transfused blood products.doc
    gigglestarsRN likes this.
  5. 1
    Quote from hotshot12345
    I don't understand this. I know of 5DW and 1/2 NS but combining them together? Would this be isotonic, hyper/hypotonic? Can somebody help me figure this out?

    thanks
    - The "best answer" given for your information leaves out one CRUCIAL bit of information. While D5 1/2 NS is hypertonic in the bag, upon intravenous administration it becomes hypotonic- because the body absorbs the glucose (almost immediatelt) leaving only 1/2 NS being absorbed into the vascular space. If this fluid is given inappropriately, it can lead to the swelling and lysis of cells.
    This solution is indicated for patients who are an prolonged NPO status. The 170 calories in a bag of D5W helps with a patient who is NPO- because they have no oral intake.
    Giving this solution and not knowing it is hypotonic on administration can be detrimental to your patient! Water intoxication, ECF osmolarity decreases, hydrostatic pressure increases, and fluids shift into the intracellular space, so all body compartments expand and dilutional electrolyte imbalances occur.
    Hope this is helpful!
    kywoodrd likes this.


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