Which of the following is a correct statement regarding 5% dextrose in 0.9% saline?
A. It contains the same concentration of sodium ions asplasmaB. 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
The answer is 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.
