Fundamentals In Nursing (Notes)

D5NM (Normosol-M) IV Fluid

Dextrose 5% in Normosol M Solution (D5NM) is a nutritional replenisher and

hypertonic solution that is nonpyrogenic.
Solution Types
 Dextrose 5% in Normosol M Solution
 Hypertonic maintenance electrolyte solution with 5% dextrose injection in
water
Classification
 Hypertonic
 Nonpyrogenic
 Parenteral fluid
 Electrolyte
 Nutrient replenisher
Contents:
 Each 1000 mL includes 5 grammes of Dextrose Monohydrate
 234 milligrams of sodium chloride
 128 milligrams of potassium acetate tetrahydrate and
 30 milligrams of sodium Metabisulfite (about 1.6 mmol/L).
Action Mechanisms
 Normosol-M with 5% Dextrose Injection supplies water and electrolytes
(with dextrose as a quickly available source of carbohydrate) for daily fluid
and electrolyte requirements, as well as low carbohydrate calories, when
taken intravenously.
 The electrolyte composition is similar to that of normal plasma's major ions
(extracellular fluid).
 In comparison to the extracellular fluid (280 mOsmol/liter), the electrolyte
content is hypotonic (112 mOsmol/liter).
  Indications of D5NMOne-liter supplies around one-third of an adult's daily
water and electrolyte requirements in balanced proportions, with acetate as
a bicarbonate substitute, and 170 calories from dextrose.
Indications of D5NM
 D5NM is intended for parenteral maintenance of daily fluid and electrolyte
needs with minimum dextrose-derived carbohydrate calories.
 Magnesium in the formula may assist patients with extended parenteral
treatment avoid iatrogenic magnesium deficit.
Contraindications
 Any component can cause hypersensitivity.
Dosage
 D5NM is available in 500 and 1000 mL single-dose flexible plastic vials.
 1000 mL per minute at 30 gtts
Responsibilities of a Nurse
 Do not use until the solution is clear and the container is in good condition.
 In patients taking corticosteroids or corticotrophin, caution should be used
while administering parenteral fluids, particularly those containing sodium
ions.
 Acetate-containing solutions should be used with caution, since too much
of it can cause metabolic alkalosis.
 Individuals with diabetes mellitus, whether preclinical or overt, should use
dextrose-containing solutions with care. Remove the unneeded piece and
discard it.
 Excessive or fast dextrose infusion in extremely low birth weight neonates
may result in elevated blood osmolality and potential intracerebral
hemorrhage.
 Label the IV Fluid Properly
 When changing IV fluid, use aseptic procedure.