dont want to be a pitn but have another question

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Specializes in corrections.

( please keep in mind i'm still new to this :) )so my patient was 3 days post mastectomy , diabetic and had d5 half ns iv at 85cc/hr,and her sodium was 135 which is borderline ( i think) so i have to give reasons for her low sodium level and i dont know why that is. maybe because she is post op and didnt have adequate sodium dietary intake because she didnt eat? or maybe its the iv? or something else???:uhoh3:

all you answers will be highly appreaciated!! :) thanks!

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Specializes in med/surg, telemetry, IV therapy, mgmt.

Sodium of 135 is a normal level. D51/2 NS does not have enough sodium in it to act as sufficient daily sodium replacement.

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Specializes in corrections.

:up::D you rock ! thanks so much

Sodium of 135 is a normal level. D51/2 NS does not have enough sodium in it to act as sufficient daily sodium replacement.
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This is what I think: Pt is taking D5 1/2 NS, which has a hypotonic effect on the body. Thus, increased fluids in the body will dilute the sodium. Also, pt is diabetic, and she might have polydipsia and increase fluids intake, which leads to hypervolemia and hyponatremia.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

a sodium level of 135 is normal and not hyponatremia!

  • normal adult:
    • 135-145 meq/liter, or (135-145 mmol/liter)

    [*]normal urine sodium:

    • 27-287 meq/24 hrs, or (27-287 mmol/24 hrs)

    [*]panic (critical) values:

    • below120 meq/liter, or above 160 meq/liter

d51/2 ns is a hypertonic solution. a hypertonic solution is one that has an osmolality (how concentrated a solution is) greater than 340 mosm/ fluid so when these solutions are infused, fluid gets pulled into the vascular system. you want to monitor kg. they are more concentrated than blood. hypertonic solutions exert more osmotic pressure than the extracellular patients receiving any hypertonic solutions for fluid overload, particularly if they are being given at a rapid rate of infusion.

[attach]5949[/attach] commonly used iv fluids

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Normal laboratory levels vary from facility to facility and 135 may not be a normal for the facility that this student is at.

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Although the sodium level is within the normal limit, the pt is still at risk for having hyponatremia. D5 1/2 NS is a hypertonic solution, with hypotonic effect in our body. I learned this from VickyRN in this thread.

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