Help with fluids/electrolytes.

[studentnursemon86]

I am having some trouble with fluids and electrolytes.

I understand that NSS with any dextrose is hypertonic and contraindicated for those NPO or at risk for dehydration.

I am confused about others like LR and D5W.

Hypertonic, hypertonic, isotonic and what they are used for.

Does anyone know a good online study tool that may help?

I found one for ABG's, but I'm having trouble with electrolytes.

[NICU Guy, BSN, RN]

Here is a link to another thread. Esme has several links that might help you.

https://allnurses.com/nursing-student-assistance/fluid-electrolytes-helpful-904973.html

[studentnursemon86]

Thank you :)

[KelRN215, BSN, RN]

Normal saline with any dextrose is most definitely not contraindicated for patients who are NPO. The most common IV fluids you'll probably see in the hospital are D5 NS and D5 1/2 NS and you will administer these to NPO patients all the time.

[StudentOfHealing]

They're NPO meaning nothing by mouth. It doesn't what goes through their IV. I give D5 1/2 NS + 20K every single day to NPO patients.

[studentnursemon86]

Like I said, I needed some clarification on the fluids.

Thank you for that.

[Esme12, ASN, BSN, RN]

https://allnurses.com/nursing-student-assistance/really-need-help-826428.html

[studentnursemon86]

I looked at those and they really helped. I took my test on Monday and I got an 81% so I passed! All of the fluid/electrolyte and ABG questions I got right except for one. I forgot that TPN is hypertonic. Now I will never forget that :)

Thank you Esme!

[studentnursemon86]

They're NPO meaning nothing by mouth. It doesn't what goes through their IV. I give D5 1/2 NS + 20K every single day to NPO patients.

From what our professor said, this is okay for short term for NPO patients, especially in post op patients.

If given long term, it could actually cause fluid volume deficit.

[KelRN215, BSN, RN]

From what our professor said, this is okay for short term for NPO patients, especially in post op patients.

If given long term, it could actually cause fluid volume deficit.

If you have a patient who's NPO long enough for that to happen, they need a lot more than maintenance IVF and would probably be on TPN.

[MattNurse, MSN, RN]

dextrose is metabolized so technically NS with anything added is hypertonic, the fact that dextrose gets metabolized really makes it an isotonic solution in the body.

[StudentOfHealing]

From what our professor said, this is okay for short term for NPO patients, especially in post op patients.

If given long term, it could actually cause fluid volume deficit.

As stated before, a patient being NPO for this long would be started on TPN. In my specialty, most of my post op patients that experience this have abdominal distention, no bm, and possible vomiting. We'll usually drop an NGT on these folks, if it doesn't progress by POD 2 then they'll be started on TPN. Some people's bowels I suppose take longer to wake up. They also have to r/o any obstructions or leaks.