When would you see D5 .45% NS w/ KCL used?

[jlevnajic]

When would you see D5 .45% NS w/ KCL used? Also why type of solution is it and what conditions or medical situations would you use it for?

[Dranger]

When would you see D5 .45% NS w/ KCL used? Also why type of solution is it and what conditions or medical situations would you use it for?

Hypotonic

Shift fluid into the intercellular from intravascular supply and help correct glucose/electrolyte imbalances I am guessing. Probably a maintenance fluid or used to correct deficiencies.

Just think it through

[IVRUS, BSN, RN]

No,

It is a hypertonic IV fluid... It's osmolarity is > than 340. And, fluid will go from ICF to ECF Intravascular.

[Asystole RN]

Trick question, it's both a hypotonic and hypertonic fluid.

When initially infused it is hypertonic but the dextrose is quickly metabolized leaving just the .45NS w/ KCL which at that point becomes a hypotonic fluid pushing free water from the intravascular space into the cells.

Think about dehydration, the first step is to correct the intravascular deficit (usually with LR or NS) if it is an isotonic dehydration (which most often is) and a maintenance fluid is given such as D5 1/2NS to push fluid from the intravascular space into the cells.

This is why D5 1/2NS (with or without the KCL) is almost never a first line fluid for rehydration.

[emcadams]

What sort of disease processes/diagnoses would D5 1/2NS+KCl be used with? Anyone have experience using it with their patients?

[ArmaniX, MSN, APRN]

I may be mistaken, but I believe this mixture has been hung on all of my DKA patients..

[Asystole RN]

What sort of disease processes/diagnoses would D5 1/2NS+KCl be used with? Anyone have experience using it with their patients?

Very common maintenance fluid used in treating dehydration. You treat dehydration in phases. I have a feeling I am wandering into homework territory but figure that the D5 is metabolized quickly and it leaves the 1/2NS with 20KCL to hydrate.

[TTRAN0710]

As this discussion seems ages ago, I've recently seen this used to treat pyloric stenosis in an infant following pyloromyotomy. But most often used in DKA patients. In most cases, it is a hypotonic solution, as many have said, the D5 is used up fairly quickly and leaving the 0.45NS. Tend to treat ICF dehydration. Hopefully you've already understood this by now =x

[Double-Helix, BSN, RN]

D5% 1/2NS c 20meqKCl/L is the standard maintenance fluids we run on all of our pediatric patients who are NPO or otherwise not able to take adequate oral/enteral fluids. It's not specific to any diagnosis.

[madninjaskillz]

I saw this used to treat hypokalemia in an elderly male patient with paralytic ileus s/p xlap sigmoidectomy. For three or four days after surgery, he was vomiting bilious gastric contents and his K was 3.1 when I saw him receiving D5 1/2NS KCl.