What IV solution is used for someone who fainted in OB?

Double-Helix, BSN, RN · Sep 15, 2011

Did she faint because of hypoglycemia or because of low fluid volume due to loss during childbirth? The answer is quite important.

If she fainted because of just hypoglycemia, she probably would not have received an IV infusion for it, unless she was unconcious. First they should try a fast acting oral form of glucose, such as juice or glucose tabs. If she needed IV glucose, and it was a short infusion, the fluid would probably be bolus of D10 or a continuous infusion of D5. D5 is available as D5W, D5NS, D5 1/2NS and D5 1/4NS, and each have different effects on fluid balance.

If she fainted because of low fluid volume, you would want a bolus of isotonic fluid- NS or Lactated Ringers- to increase the vascular volume.

As far as how much fluid she got, I can't give you an answer there. That would depend on her size, how low the glucose was, how urgent the situation, how quickly she recovered, etc.

Student2001 · Sep 15, 2011

She fainted because she was hypoglycemic, most likely. so since D5NS is hypertonic.. how would this help her with fluid balance and why would it be used instead of the other D5`s?

ckh23, BSN, RN · Sep 16, 2011

Ashley provided some good info, but I disagree slightly. If this patient was that hypoglycemic that they "passed out" and they are in a hospital, they are getting D50 to bring them back around.

From what you described still sounds like an orthostatic hypotensive event, but you have a glucose level to the contrary then I guess that is the reason. Do you really know she was hypoglycemic?

D5 is hypertonic out of the bag. Once in the body the dextrose is metabolized rather quickly and the solution really becomes NS which is isotonic and will help restore circulating volume.

ashleyisawesome, BSN, RN · Sep 16, 2011

She fainted because she was hypoglycemic, most likely.

what does that mean? did she have a low blood glucose or not?

Student2001 · Sep 17, 2011

I didn`t find her blood sugar values so i am not sure if she was hypoglycemic. this was our 1st day in clinical and we were not allowed into the computer systems yet and that is where this information would be. i didn`t ask anyone to look for me because it was just a very stressful hectic day. anyways, thank you everyone for your help!

EricJRN, MSN, RN · Sep 17, 2011

Consider also that fainting can be related to vasovagal issues - where stress, fear, anxiety, hunger, thirst and just about any other stressor can come into play. You'll see it in squeamish hospital visitors, especially in L&D, but also in patients. Those patients usually come back around very quickly, often immediately after passing out. They usually look a lot better after some basic comfort measures like a cool cloth to the forehead or a cool drink. No IV is usually needed.

Fainting that occurred on standing might suggest a low fluid volume. You'd have to dig further though. How much blood loss? Vitals? Assessment of skin color and turgor?

Loss of consciousness related to hypoglycemia is often going to be a progressive thing that starts with shakiness, sweating, behavior changes or things like that. Was the patient diabetic? Was the patient awake by the time the IV fluids were started?

That sounds like a busy first day. It's really hard to piece together this sort of scenario without a lot of the assessment data, but it's a good learning experience on the importance of making sure that you assess the patient and that you bug someone for at least some of the relevant info. Good luck to ya!

akulahawkRN, ADN, RN, EMT-P · Sep 17, 2011

While I'm a very new student nurse, I'm not new to patient care. Reading the issue, a couple things come to mind. The presentation is so classic... for orthostatic hypotension. Think about what's happened recently to the patient. She's just given birth (fluid loss) and likely hasn't had sufficient fluids given to replace the lost volume. She's been supine in bed for a long time and was stood up. That amount of activity normally doesn't make someone go from conscious to unconscious from burning calories (the hypoglycemia thought...).

If she was that hypoglycemic where she became unconscious, they'd be likely providing D25 or D50 to bring the blood glucose levels up sharply. I doubt this was needed.

My feeling is that the patient probably got a bolus of D5NS or LR to increase intravascular volume. These are all either isotonic or isotonic with a slight osmolar pull... Chances are that's all that needed to be given.

Now something that does need to be checked out is how much fluid was lost during the birthing process, skin signs, any labs that done, vitals... and so on. It might actually be a very good study for what happens (probably fairly commonly) to patients in L&D...

Isabelle49 · Sep 20, 2011

Agree with D50 IV bolus if unconscious and cannot swallow.