Fundamentals of Nursing Q 314
A nurse is making initial rounds at the beginning of the shift and notices that the parenteral nutrition (PN) bag of an assigned client is empty. Which of the following solutions readily available on the nursing unit should the nurse hang until another PN solution is mixed and delivered to the nursing unit?
A. 10% dextrose in water.
B. 5% dextrose in water.
C. 5% dextrose in normal saline.
D. 5% dextrose in lactated Ringer solution.
Correct Answer: A. 10% dextrose in water.
The client is at risk of hypoglycemia. Hence the nurse will hang a solution that has the highest amount of glucose until the new parenteral nutrition solution becomes readily available. Crystalloid fluids are a subset of intravenous solutions that are frequently used in the clinical setting. Crystalloid fluids are the first choice for fluid resuscitation in the presence of hypovolemia, hemorrhage, sepsis, and dehydration.
Option B: Option B is also a crystalloid fluid, but contains less glucose than option A. Other clinical applications include acting as a solution for intravenous medication delivery, to deliver maintenance fluid in patients with limited or no enteral nutrition, blood pressure management, and to increase diuresis to avoid nephrotoxic drug or toxin-mediated end-organ damage.
Option C: Dextrose 5 in .9 Sodium Chloride is a prescription medicine used to treat the symptoms of hypoglycemia. Dextrose 5 in .9 Sodium Chloride may be used alone or with other medications. Dextrose 5 in .9 Sodium Chloride belongs to a class of drugs called Glucose-Elevating Agents; Metabolic and Endocrine, Other.
Option D: 5% Dextrose in Lactated Ringer’s Injection provides electrolytes and calories, and is a source of water for hydration. It is capable of inducing diuresis depending on the clinical condition of the patient. This solution also contains lactate which produces a metabolic alkalinizing effect.