Appropriate IV for pneumonia???

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    I am doing a case study to make up a clinical day and have been stuck on one question for hours. We have not learned IV's yet. The question is is IVF of D5 1/2 NS at 125 ml/hr appropriate for a pneumonia pt? Why or why not? It's a normally healthy 71 year old male. Thank you. :/
  2. 3 Comments so far...

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    I think the rate is ok as long as this pts heart is fine..but idk about the type...I think the MD should make that call
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    I agree with above poster. I have just a little to add to help you go into the right direction (hopefully).

    Is D5 1/2 NS appropriate for pneumonia? How does one determine this? First:

    We need to determine tonicity. Or, in other words, is this fluid hypertonic, hypotonic, or isotonic? Once you figure out tonicity, you should be able to determine what is happening to the cells (action of the fluid). Once you figure the cellular issue, you should be able to determine a general reason for this fluid with pneumonia.

    Furthermore, what are the type of solutes/substances are in this fluid? What are their purpose?

    It's important to be generally familiar with the pathophysiology of pneumonia. Your familiarity will help you determine the reason for the fluid as well as if this particular fluid would be appropriate.

    I agree that this would be an MD call as well as probably vary by preference. However, if we understand the action of the fluid and the pathophysiology, we could generally determine the appropriateness of the fluid. Fluids are a medication too. We have to be aware if these are appropriate and safe for the patient.

    Good luck!

    -Andrew
    Last edit by Floridatrail2006 on Mar 28, '13
  5. 0
    Quote from jennys77
    I am doing a case study to make up a clinical day and have been stuck on one question for hours. We have not learned IV's yet. The question is is IVF of D5 1/2 NS at 125 ml/hr appropriate for a pneumonia pt? Why or why not? It's a normally healthy 71 year old male. Thank you. :/
    I'm sure you will find these helpful.

    able of commonly used iv solutions.doc - most commonly used iv solutions; includes tonicity, ph, the ingredients of the solutions, its uses and complications
    index
    http://www.merckmanuals.com/professi...scitation.html
    http://www.pana.org/Power%20Point%20...tes%20PANA.pdf
    The body’s response to fluid and electrolyte abnormalities is multi-factorial. The first concern, therefore, starts with oxygenation and ventilation, then circulation and, last, acid-base and electrolytes.

    When altered, fluids and electrolytes should be corrected in the following order: (a) volume; (b) pH; (c) potassium, calcium, magnesium; and (d) sodium and chloride. Reestablishing tissue perfusion often equalizes the fluid-electrolyte and acid-base balance. Because the osmolarity of normal saline (NS) matches that of the serum, it is an excellent fluid for volume replacement.

    Hypotonic fluids such as D5W should never be used to replace volume. Lactated Ringer’s (LR) solution is commonly used for surgical patients or trauma patients, however, only NS can be given in the same line with blood components. D5.45 NS, with or without potassium, is given as a maintenance fluid. The more concentrated dextrose solutions, D10W or D20W are used for patients with compromised ability to mobilize glucose stores


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