Published Feb 1, 2015
nursejl1
49 Posts
When would you choose D5NS, over NS or D5 1/2NS?
ellieheart
35 Posts
Nurses don't prescribe. Physicians do that.
LoveMyBugs, BSN, CNA, RN
1,316 Posts
What does each one do?
D5 has sugar in it, so if your pt is NPO for say the OR in the am would you rather get D5 or NS? Why?
anh06005, MSN, APRN, NP
1 Article; 769 Posts
Nurse PRACTITIONERS can. This was posted in the student NP forum.
I had to double check where it was posted myself cause I just go to newest on the phone app and the font is a bit small where it lists the board name lol.
Anyway OP I have always been curious about this too. I do understand D5 probably being useful on NPO pts as PP said but beyond that the osmolality (or osmolarity??) stuff gets jumbled in my head.
yes, of course- we all know that, but you're in the nurse practitioner forum.
zmansc, ASN, RN
867 Posts
A complete answer would be too long for a post in a forum, however I'll try to make a synopsis of some of the points here:
1) Fluids are given to either keep the patient from dehydrating, or rehydrate the patient.
2) Both electrolytes and nutritional status must be considered when selecting the proper fluid for the patient.
By nutritional status, I mean not only their current and near term dietary intake (NPO, etc), but aspects that are known to have altered their metabolism (post-op, etc).
I'm sure there are other aspects that need to be considered I'm not thinking of off the top of my head, but those are the main ones that come to mind in a pinch!
Taking these into account, dehydration status, known electrolyte and nutritional needs you would select the fluid that best fits those needs.
D5 is a good solution for the typical OR situation as it helps to keep the balance between starvation reactions and hyperglycemia.
In ERs where we are mostly interested in stabilizing the vitals rehydration is often done with NS.
In situations where the patient is able to maintain their own nutritional status (eat) NS, NS + 20K, etc are the more typical fluid solutions.
BTW, none of this comes from my NP education, I was curious about it when I first started in the hospital as a RN, so I researched it. Google scholar is a great resource for this kind of information!
NucRN
41 Posts
Just went over this stuff in pharmacology. D5 is definitely given for NPO status. I also agree with changing combinations based on electrolytes.