D5NM (Normosol-M) IV Fluid

 Description

Dextrose 5% in Normosol M Solution (D5NM) is a hypertonic solution that is nonpyrogenic and is a nutrient replenisher.

Type of Solution
  • Dextrose 5% in Normosol M Solution
  • Hypertonic solution of balanced maintenance electrolytes and 5% dextrose injection in water for injection
Classification
  • Hypertonic
  • Nonpyrogenic
  • Parenteral fluid
  • Electrolyte
  • Nutrient replenisher
Contents
  • Each 1000 mL contains 5g of Dextrose Monohydrate,
  • 234 mg of sodium chloride
  • 128 mg of potassium acetate tetrahydrate and
  • 30mg (approximately 1.6 mmol/L) of sodium Metabisulfate.
Mechanism of Action
  • When administered intravenously, Normosol-M and 5% Dextrose Injection provides water and electrolytes (with dextrose as a readily available source of carbohydrate) for maintenance of daily fluid and electrolyte requirements, plus minimal carbohydrate calories.
  • The electrolyte composition approaches that of the principal ions of normal plasma (extracellular fluid).
  • The electrolyte concentration is hypotonic (112 mOsmol/liter) in relation to the extracellular fluid (280 mOsmol/liter).
  • One liter provides approximately one-third of the average adult daily requirement for water and principal electrolytes in balanced proportions, with acetate as a bircarbonate alternate,plus 170 calories from dextrose.
Indications of D5NM
  • D5NM is indicated for parenteral maintenance of routine daily fluid and electrolyte requirements with minimal carbohydrate calories from dextrose.
  • Magnesium in the formula may help to prevent iatrogenic magnesium deficiency in patients receiving prolonged parenteral therapy.
Contraindications
  • Hypersensitivity to any of the components.
Dosage
  • D5NM is supplied in single-dose 500 and 1000 mL flexible plastic containers.
  • 1000 mL @ 30 gtts/min.
Nursing Responsibilities
  • Do not administer unless solution is clear and container is undamaged.
  • Caution must be exercised in the administration of parenteral fluids, especially those containing sodium ions to patients receiving corticosteroids or corticotrophin.
  • Solution containing acetate should be used with caution as excess administration may result in metabolic alkalosis.
  • Solution containing dextrose should be used with caution in patients with known subclinical or overt diabetes mellitus.
  • Discard unused portion.
  • In very low birth weight infants, excessive or rapid administration of dextrose injection may result in increased serum osmolality and possible intracerebral hemorrhage.
  • Properly label the IV Fluid
  • Observe aseptic technique when changing IV fluid