TREATMENT/ CLASSIFICATION INDICATION CONTRAINDICATION NURSING RESPONSIBILITIES

INFUSION
D5LR Hypertonic Replacement therapy • Renal failure 1. Never stop hypertonic solutions abruptly.
Solution particularly in • Liver dysfunction 2. Don’t give concentrated solutions I.M. or
extracellular fluid • Diabetes Mellitus subcutaneously.
deficit accompanied • Lactic acidosis 3. Monitor glucose level carefully.
by acidosis • Alkalosis 4. Check vital signs frequently. Report adverse
Hyperkalemia reactions.
5. Monitor fluid intake and output and weight
carefully. Watch closely for signs and symptoms of
fluid overload.
6. Monitor patient for signs of mental confusion
D5W Isotonic solution used to supply water 1.Patients at risk for increased I.C.P. 1. Do not administer quantity in excess of that
and calories to the 2. Patients who have an acute required to keep vein open or administer
body neurological dysfunction. appropriate dose of medication.
3. Hypovolemic states. 2. Do not use solution if outdated, cloudy or the
4. Patients at risk for third-space fluid seal is not intact, as with all IV solutions.
shifts. 3. Monitor E.C.G. continuously.
5. Elevated blood glucose 4. Monitor blood pressure, pulse rate and
concentrations. respiratory rate frequently.
6. heart problems (e.g., congestive
heart failure), 7.kidney problems,
fluid balance problems (e.g.,
hypovolemia),
8.low levels of potassium
(hypokalemia)
9.vitamin B deficiencies
10.swelling (edema).
D5NM Hypertonic • Maintenance • Contraindicated in patient in 1. Never stop hypertonic solutions abruptly.
Solution of fluid and diabetic coma while glucose level 2. Don’t give concentrated solutions I.M. or
electrolytes. remains excessively high. subcutaneously.
Maintenance therapy • Use cautiously in patients 3. Monitor glucose level carefully.
for major surgical with cardiac or pulmonary disease, 4. Check vital signs frequently. Report adverse
procedures, burns, hypertension, renal insufficiency, reactions.
colostomies, etc. urinary obstruction, or hypovolemia 5. Monitor fluid intake and output and weight
carefully. Watch closely for signs and symptoms of
fluid overload.
6. Monitor patient for signs of mental confusion