Please someone help me with these meds.

suni, BSN, RN · Dec 6, 2007

What you need to look for is which of these fluids is isotonic, hypertonic and or hypotonic and then what are the adverse reactions of giving the wrong fluid.

Meds should not be too difficult to look up, there are plenty of sites just type in the word and search.

Daytonite, BSN, RN · Dec 6, 2007

1. d5/0.9% nacl

also written as 5% dextrose in 0.9% sodium chloride or the shorthand notation of d5ns. it is a hypertonic solution with a ph of 4.4. its composition is 5 grams of dextrose, 154 meq of sodium and 154 meq of chloride. it is used as a hypertonic fluid replacement, to replace sodium and chloride and some calories. hypertonic solutions exert more osmotic pressure than the extracellular fluid so when these solutions are infused, fluid gets pulled into the vascular system. you want to monitor patients receiving any hypertonic solutions for fluid overload, particularly if they are being given at a rapid rate of infusion.

2. d5/0.45% nacl

also written as 5% dextrose in 0.45 sodium chloride or the shorthand notation of d5½ns. it is a hypertonic solution with a ph of 4.4. it's composition is 5 grams dextrose, 77 meq sodium, and 77 meq chloride. it is used as a hypertonic fluid replacement, to replace sodium and chloride and some calories. hypertonic solutions exert more osmotic pressure than the extracellular fluid so when these solutions are infused, fluid gets pulled into the vascular system. you want to monitor patients receiving any hypertonic solutions for fluid overload, particularly if they are being given at a rapid rate of infusion.

3. 0.45% nacl

the shorthand notation for this solution is 1/2 ns. it is a hypotonic solution with a ph of 5.6. it contains 77 meq sodium and 77 meq chloride. it is used for hypotonic hydration, to replace sodium and chloride, and in hyperosmolar diabetes. hypotonic solutions exert less osmotic pressure than the fluid in the extracellular compartment which allows water to be drawn from the extracellular fluid. blood cells will draw this solution into them causing the blood cells to swell and burst. continuous infusion can cause dilution and depletion of electrolytes because of the small amount of sodium in this particular mixture resulting in hyponatremia. because there are no calories in the solution, the patient is going to become calorie depleted as well if it is infused for a long period. this is the only hypotonic iv solution that is used.

4. adh (antidiuretic hormone) (vasopressin)

adh is a posterior pituitary hormone produced in the pituitary gland whose primary function is to regulate water balance in the body. when it is released it goes to the kidneys via the blood where it increases the reabsorption of water back into the blood (otherwise, we would dehydrate from the kidneys dumping water out of our system) in the kidneys under the influence of adh the pores of the collecting ducts open, and water rushes toward the sodium ions resulting in water being removed from the urine and urine volume decreases. the natural form of this hormone that is produced in the body is known as adh (antidiuretic hormone). the drug form of it that is administered by healthcare personnel is known as

vasopressin.

vasopressin also causes vasoconstriction. it is used in the treatment of diabetes insipidus, abdominal distention, for bleeding esophageal varices and to lower blood pressure because of it's effects on the blood vessels. contraindications include hypersensitivity to the drug or a history of chronic nephritis. alcohol ingestion blocks adh which decreases the renal reabsorption of water, so more urine is produced. that is why when you are drinking alcohol you have to pee more.

5. aldosterone (florinef)

aldosterone is a mineralocorticoid hormone that is released from the adrenal cortex and which causes the retention of sodium. aldosterone causes the kidneys to reabsorb more sodium and therefore reabsorb more water back into the blood. this results in increased blood volume and blood pressure. in exchange for the sodium ions that are reabsorbed potassium ions are secreted into the urine via the renal tubules. aldosterone receptors in the renal tubules interact with the aldosterone to cause intracellular potassium ions to enter the tubular fluid (urine) so they are excreted while sodium is retained. (sodium-potassium exchange) because water is also retained with the sodium the isotonic water levels of the blood and other body tissues are maintained because of the action of aldosterone. major side effects of the use of aldosterone as a drug are edema, hypertension and muscle weakness because of the loss of potassium and retention of water. the edema could lead to congestive heart failure. it is administered as a drug called florinef (fludrocortisone) and is used in adrenal insufficiency. it is contraindicated if the patient is hypersensitive to it, in acute glomerulonephritis, amebiasis, psychosis, cushing's syndrome, and fungal infections.

6. 0.9% nacl

the shorthand notation for this is ns. it is an isotonic solution with a ph of 5.7. it contains 154 meq sodium and 154 meq chloride. it is used for hydration, to replace sodium and chloride, for alkalosis, and blood transfusions because it will not hemolyze blood cells. isotonic solutions have the same tonicity as plasma so that when they are infused into a vein, water neither enters or leaves the cells. they have the same concentration as blood. isotonic iv solutions are used to expand the extracellular fluid volume and do not cause any fluid to move from into or out of the blood cells.

i posted information on the hypotonicity, isotonicity and hypertonicity of iv solutions on post #22 of this sticky thread in this forum:

https://allnurses.com/forums/f205/any-good-iv-therapy-nursing-procedure-web-sites-127657.html - any good iv therapy or nursing procedure web sites