can someone pls explain to me?

[tokidokifantasy]

so the question on the test was, if the pt's BP was 55/34, showing sign of orthostatic hypotension, what IV fluid would you administer and why?

1.NS

2.D5W

3. D51/2NS

4.D10W

can someone pls explain to me the rationale.

I picked D5W, pt is dehydrated, no blood volume, so pt is in need to expand vascular compartments, but my answer was wrong.

thanks!

[chulada77, ADN, BSN, MSN, APRN]

so the question on the test was, if the pt's BP was 55/34, showing sign of orthostatic hypotension, what IV fluid would you administer and why?

1.NS

2.D5W

3. D51/2NS

4.D10W

can someone pls explain to me the rationale.

I picked D5W, pt is dehydrated, no blood volume, so pt is in need to expand vascular compartments, but my answer was wrong. Also, I've seen several dialysis pts in this situation and NS has been our fluid of choice.

thanks!

I'd go with NS just because you are in need of the volume AND you need to use process of elimination. why would you pick D5W over D10W, because essentially they fall under the same category of fluids. Right off the bat I would've of eliminated 3 and 4 and then 2.

Also wouldn't you need more information to have chosen d5w?

It's been a few moments since I've been in school but I'm just using my own rationale, so which is correct anyway?

[tokidokifantasy]

LOL! well D5W is isotonic , so is NS, they are both vascular expander.

that's why I picked D5W, but the answer is NS. I just don't understand why it isn't D5W because they are both isotonic solution and their purposes are the same.

[tokidokifantasy]

and btw, D10W is hypertonic. so I know it's not right.

[chulada77, ADN, BSN, MSN, APRN]

and btw, D10W is hypertonic. so I know it's not right.

Again, been awhile from school days but through experience a normal dehydration and low bp, we give NS. I can't honestly think of a time that d5w has been chosen over NS but I'm sure somebody can expand on that.

I can only go off experience which helps you none! Sorry!

[tokidokifantasy]

thank you though! my teacher said that D5W isn't wrong, but just not the best answer. lol. I wish there was a better rationale from her side.

[chulada77, ADN, BSN, MSN, APRN]

so the question on the test was, if the pt's BP was 55/34, showing sign of orthostatic hypotension, what IV fluid would you administer and why?

1.NS

2.D5W

3. D51/2NS

4.D10W

can someone pls explain to me the rationale.

I picked D5W, pt is dehydrated, no blood volume, so pt is in need to expand vascular compartments, but my answer was wrong.

thanks!

I've been thinking about it and have a couple thoughts on d5w vs. ns. NS is your first line of defense/most common and anything can be piggybacked with ns but not d5w. The dextrose gets absorbed which is how this is considered "isotonic" but if you are already hypovolemic I'm wondering how the dextrose would throw off the f&e of the pt.

[CA_BSN_Student]

I agree with chulada77. NS is the first line of defense and sometimes LR (lactated ringer) is used for volume replacement. I believe they are most compatible to our intravascular fluids and can be mixed with almost any IV drugs. D5W might work but it's not the best answer.

[ukstudent]

Where in the test question did it say that the pt is dehydrated? Or did you not write out the entire test question? There are several reasons that a pt could have a blood pressure like that including internal blood loss and sepsis.

That said D5W is isotonic only while in the bag, it becomes hypotonic once it gets into a pt's blood stream. If given in large amounts it will reduce the sodium levels, which can lead to seizure and death. Why would you choose to give a fluid that can lead to seizure and death when you have a perfectly good isotonic solution that will not reduce the pt's sodium level in NS?

If you had a pt that was dehydrated (not in the question) and had a high sodium level (not in the question) then D5W could be given. You read too much into the question.

[tokidokifantasy]

I've been thinking about it and have a couple thoughts on d5w vs. ns. NS is your first line of defense/most common and anything can be piggybacked with ns but not d5w. The dextrose gets absorbed which is how this is considered "isotonic" but if you are already hypovolemic I'm wondering how the dextrose would throw off the f&e of the pt.

Ok!! I understand now! it makes sense now. I wish the teacher would explain better in her lecture. She basically said all isotonic solutions are vascular expander, they are used to treat hypovolemic shock and basic maintenance. If it was explained like everyone else here did, it would have been understood by everyone in the class. thank you all for your help!