The nurse is to administer an intravenous solution to a patient with diffuse edema. This will pull fluid from the interstitial space to the intravascular space. Which prescription would the nurse question for this patient? A prescription for:
a. 5% Dextrose in water (D5W)
b. 10% Dextrose in water (D10W)
c. 5% Dextrose in normal saline (D5 0.9% NaCl)
d. 5% Dextrose lactated Ringer's (D5LR)
A
Edema is the presence of excess fluid within the interstitial spaces. Hypertonic fluids, when administered, pull fluids and electrolytes from the intracellular and interstitial compartments into the intravascular compartment. Hypertonic fluids can help stabilize blood pressure, increase urine output, and reduce edema. D10W, D5 0.9% NaCl, and D5 LR are all hypertonic fluids, so the nurse would likely not question a prescription for one of those. D5W, however, is hypotonic in the body, with a tendency to pull fluids out of the intravascular compartment into the interstitial compartment, and thus increase the patient's edema.
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