Fluids to help a vomiting patient?

[nurs1ng]

What's usually prescribed to lessen a patient from vomiting? Is it D5, D51/2NS, or NS?

I overheard my co worker talk to the doctor that the patient is still on "D5" (not sure if he meant D5 or D51/2NS) & that the pt has been vomiting... and the doctor sort of got upset because pt was supposed to be on NS.

I understand the idea behind hypotonic, hypertonic, and isotonic solutions... but what's the patho behind it when it involves vomiting?

Thanks for any response!

[Rhi007]

When I was puking for 4days straight and the smell of food made me gag, I was on NS and barley sugar lollies

[classicdame, MSN, EdD]

You want an isotonic fluid so NS is generally preferred. The cells are getting dehydrated. Sometimes they add K+

Hypotonic fluids will bring water from the cells to the blood vessel - and dehydrate cells further

Hypertonic fluids will bring water to the cells from the blood vessel, but in this instance they will dehydrate the blood vessels and the blood vessels are probably dehydrated just like the cells, so you would have two problems and one concerns circulation.

[PediLove2147, BSN, RN]

Maybe I am mistaken but the fluids aren't helping with the vomiting, they are preventing dehydration related to the vomiting. The patient needs medication to help prevent that or figure out why they've been vomiting for 4 days.

[nurseprnRN, BSN, RN]

What's usually prescribed to lessen a patient from vomiting? Is it D5, D51/2NS, or NS?

I overheard my co worker talk to the doctor that the patient is still on "D5" (not sure if he meant D5 or D51/2NS) & that the pt has been vomiting... and the doctor sort of got upset because pt was supposed to be on NS.

I understand the idea behind hypotonic, hypertonic, and isotonic solutions... but what's the patho behind it when it involves vomiting?

Thanks for any response!

You lose a lot of sodium with vomitus, and loss of sodium plus addition of plain water (which is what D5W is once the sugar is metabolized, very rapid) results in decreased serum sodium. This, in turn, has a lot of bad effects, notably cerebral edema.

If the vomiting in this patient was caused by increased intracranial pressure in the first place, so much the worse to give D5W.

[nurs1ng]

I knew that fluids helped with dehydration by my co worker made it seem like it helped lessen vomiting . I just wanted to confirm and make sure I wasn't going crazy. Thanks guys

[blondy2061h, MSN, RN]

Occasionally if a person is vomiting for awhile they can get a bit hypoglycemic and hypoglycemia can cause nausea which can perpetuate things further, so adding a bit of dextrose can help things stop if that is the case, but it would be something like D5NS not D5W for the reasons Grntea and Classicdame mentioned.

[IVRUS, BSN, RN]

You want an isotonic fluid so NS is generally preferred. The cells are getting dehydrated. Sometimes they add K+

Hypotonic fluids will bring water from the cells to the blood vessel - and dehydrate cells further

Hypertonic fluids will bring water to the cells from the blood vessel, but in this instance they will dehydrate the blood vessels and the blood vessels are probably dehydrated just like the cells, so you would have two problems and one concerns circulation.

An isotonic IVF will provide volume lost from the vomiting episodes. NS or LR is appropriate. However, your getting your hyper, hypo mixed up. A hypotonic IV fluid will leave the blood vessel and hydrate the cells. So, in the case of cellular dehydration, a hypotonic fluid could be appropriate (This is not the case here, however). Hypotonic fluids like D5W may also be used to carry Na+ into the cells to correct hypernatremia. (This is not the case here, however). A Hypertonic fluid will dehydrate the cells, as fluids move from ICF, to Intravascular ECF.