NAME OF THE FLUID 5 % dextrose in lactated ringers (D5LR) Electrolytes in 1000 ml Sodium-130mmol Potassium-4 mmol Calcium-1.

4mmol Chloride-109 mmol Lactate-28 mmol

CLASSIFICATION & ACTION Hypertonic Solution Nonpyrogenic, parenteral fluid, electrolyte and nutrient replenisher

INDICATION Replacement therapy particularly in extracellular fluid deficit accompanied by acidosis Treatment of shock Persons needing extra calories who cannot tolerate fluid overload

SIDE EFFECTS Increased serum osmolality Hypernatremia Hypokalemia Altered thermoregulatio n Pulmonary edema Cardiovascular overload

CONTRAINDICATIO N Renal failure Heart disease Dehydration Liver dysfunction Diabetes mellitus Lactic acidosis Alkalosis Hyperkalemia

NURSING RESPONSIBILITIES Watch out for signs of hypervolemia Do not administer unless solution is clear and container is undamaged. Never stop hypertonic solutions abruptly. Dont give concentrated solutions IM or subcutaneously . Check vital signs frequently. Report adverse reactions. Monitor fluid intake and output and weight carefully. Watch carefully for signs and symptoms of fluid overload. Monitor patients for signs of mental confusion.

MONITORING PARAMETERS Monitor glucose level carefully. Monitor for sodium, potassium and serum osmolality.

Hypertonic solutions are those that have an effective osmolarity greater than the body fluids. These solutions draw fluid out of the intracellular and interstitial compartments into the vascular compartment, expanding vascular volume. It raises intravascular osmotic pressure and provides fluid, electrolytes and calories for energy.

Lung sounds are frequently auscultated to detect signs of fluid accumulation.