Which of the following is a correct statement regarding 5% dextrose in 0.9% saline?
A. It contains the same concentration of sodium ions asplasma
B. It can be given in large quantities without seriously affecting acid-base balance
C. It is isosmotic with plasma
D. It may cause a dilutional acidosis
A. It contains the same concentration of sodium ions asplasma
B. It can be given in large quantities without seriously affecting acid-base balance
C. It is isosmotic with plasma
D. It may cause a dilutional acidosis
Ans. D. It may cause a dilutional acidosis
Isotonic saline solutions
contain 154 meq of both sodium and chloride ions. Each ion is in a
substantially higher concentration than is found in the normal serum (Na = 142 meqCl 103 meq. When isotonic solutions
are given in large quantities, they overload the kidney's ability to excrete
chloride ion, which results in a dilutional acidosis.They also may intensify pre existing
acidosis by reducing the base bicarbonate acid ratio in the body Isotonic
saline solutions are particularly useful in hyponatremic or hypochloremic states
and whenever a tendency to metabolic alkalosis is present, as occurs with
significant nasogastric suction losses or vomiting.
Administration
of lactated Ringer's solution is appropriate for replacements gastrointestinal
losses and correcting extracellular fluid deficits. Containing 130 meq sodium
lactated Ringer's is. hyposmolar with respect to sodium and provides
approximately 150 mL of free water with each liter given. Although this is
ordinarily not a significant load, in some clinical condition - it can be.
Lactated Ringer's is sufficiently physiological to enable administration of
large amounts without significantly affecting the body's acid-base balance. It
is worth noting that both isotonic saline and lactated. Ringer's are acidic
with respect to the plasma: 0.9% NaC1/5% dextrose has a pH of 4.5 while lactated Ringer's has a
pH of 6.5.
