Hopefully someone will be able to give me answers to my questions. I am going to be giving an in service on Hypodermoclysis . Only one article that I read states that D5W can be used. the literature states that isotonic solutions are the solutions of choice. The IV route, to my understanding, D5w is usually given for Hypernatremia. I know that this solution will hydrate, but not the solution of choice. The body metabolizes the dextrose during infusion and only water is left. This is why we give it o patients with hypernatremia. Other side effects of D5W would be cerebral edema and water intoxication, so the patient with a normal sodium would not receive this. The only other condition that we would use D5W would be SIADH. What I can't find is, what happens to the dextrose when it is infusion SC? Will there be a fluid shift between the intracellular and interstitial space, like if giving a hypertonic solution? The dextrose question is the big question for me. D5 1/2 NS, D5NS are hypertonic solutions, but what happens during infusion, do they be come hypotonic due to metabolism of dextrose? I know that someone will ask my about using D5W for Clysis and I would like to know how to respond.
Thank you for your help. Warren Willard
Forum topic
Sun, 07/24/2016 - 17:57
#1
Clysis
See the INS Standard of Practice #56 Continuous Subcutaneous Infusion and Access Devices, with 8 references about the specific fluids. Metabolism would take place at the cellular level, and not inside the blood stream.. Same thing would happen with SC glucose- metabolized by cells. There is also a chapter in the INS textbook Infusion Nursing: An Evidence Based Approach. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861