question!

[bananalove]

is d5 1/2 ns normally prescribed for vomiting, what are the contraindications, adverse reaction?

[Liddle Noodnik]

I dunno me, I usually have seen 0.9 NS. why do you ask?

[bananalove]

i noticed that one of our doctors usually order d5 1/2 ns for cases like vomiting or hydration... i want to be more familiar with it because we keep on giving it but i dont have that much of an idea about it. i know its a hypertonic solution but i was wondering if its safe to give for cases like vomiting

[bananalove]

someone help plsss

[Liddle Noodnik]

i noticed that one of our doctors usually order d5 1/2 ns for cases like vomiting or hydration... i want to be more familiar with it because we keep on giving it but i dont have that much of an idea about it. i know its a hypertonic solution but i was wondering if its safe to give for cases like vomiting

what I did was enter in yahoo search, "d5 1/2 s for vomiting", and got a lot of different sites, you can do that on most every question - actually the search engine will often direct you to a thread here on ALLNURSES for the answer, lol! so to shortcut it, you could just enter that same search terminology, "d5 1/2 s for vomiting" on the Allnurses search engine. The nurses here are pretty good IMHO :) I am very impressed quite often!

ANYway all I could find concrete was that for SHORT term use the D5 1/2 S is going to pull the fluid out of the cells and compensate for the loss of fluid and/or sodium/sugar that was lost in vomiting. I found that that was the common standing order for vomiting. Of course you wouldn't want to continue it for long ... I would assume after a L or two of the D5 1/2 S they would switch to a more compatible solution, to replace just fluid lost.

[bananalove]

you're so good thank you so much, yah usually only for 1 or 2 L only then dc :)

[mauxtav8r]

Ok, I'm not great at chemistry, and I don't mean to argue, but isn't the point of d 5 1/2 ns to PUSH water into cells via osmosis?

The dried up cells (dehydrated due to vomiting, water loss, etc.) are exposed to watery 1/2 normal saline with dextrose in it (d5). The cells swell.

After fluid balance is restored, then the fluid is switched to ns or something else.

I don't know for sure, but some side effects or adverse effects might relate to over-hydration of the cells, fluid overload, edema, etc. If there is renal compromise you might get into trouble there. CHF, same. Diabetes, sugar issues.

Best wishes.

[larema]

D51/2 ns is hypertonic (it's osmolality is 406 mOsm/L) and

the way I remember it is

The cell will cRenate (shRink) when the solution is hypeRtonic.

The cell will swell when it's hypotonic.

Any fluid with an osmolality greater than 300 will pull water OUT of the cells/ less than 270 will force water INTO cells.

All the same--just ask the doctor why he chooses it; I do this often and usually end up learning something I would have never learned otherwise

[Ivanna_Nurse, BSN, RN]

Hey guys! d5 1/2 is hypertonic until the dextrose is metabolized, then it would be hypotonic. As others have said, its standard for a liter or two, then swapped out.

cerebral edema, chf, elevated glucose are the only things that come to mind for adverse events, and those really depend more on the rate and volume.

Have a good day, Ivanna

[jammin246RN]

Yes, it is hypertonic until it metabolizes then becomes hypotonic. It can help replace some calories lost by not being able to eat.... and help restore sodium and clorine ions. Also it is good at replacing fluid in the vessels and cells. A very common solution we give is D5 1/2 ns + 20meq K.