A patient with a serious gastrointestinal bleed arrives in the emergency department and the physician intends to initiate aggressive intravenous therapy. Which solution would the nurse anticipate being used to manage this patient's condition?

Question

1. D5 and NS
2. D5W
3. 0.9% NS
4. 0.45% NS

Answer 1

3
Rationale 1: Dextrose 5% and 0.9% Normal Saline is a hypertonic solution that is not used for aggressive fluid replacement.
Rationale 2: D5W is a hypotonic fluid that will not stay in the vascular space but rather will be absorbed by the cells. This fluid will not increase intravascular volume.
Rationale 3: Aggressive intravenous management of a patient with gastrointestinal bleeding is done with an isotonic crystalloid solution such as 0.9% NS. This type of fluid will provide intravascular fluid replacement to the depleted circulating fluid. This is done until the patient can be typed and crossed-matched for blood replacement therapy.
Rationale 4: 0.45% NS is a hypotonic fluid that will not stay in the vascular space but rather will be absorbed by the cells. This fluid will not increase intravascular volume.