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Administering D50 safely.



Dextrose dextrose: see glucose.  50% (D50) is often given as an intravenous bolus to patients who have hypoglycemia hypoglycemia: see diabetes.
hypoglycemia

Below-normal levels of blood glucose, quickly reversed by administration of oral or intravenous glucose. Even brief episodes can produce severe brain dysfunction.
, but many of us have never been taught how to properly administer D50. As the name implies D50 is 50 percent dextrose in water. This makes for a highly concentrated and very thick solution. If D50 infiltrates into the tissue, it can cause tissue sloughing and necrosis and if D50 is given to rapidly it can cause sclerosis of the vein.

Yes, D50 is sugar water--but it's very concentrated sugar water. D50 has a pH of 4. That's like stomach acid! And it is very hyperosmolar with an osmolality osmolality /os·mo·lal·i·ty/ (oz?mo-lal´it-e) the concentration of a solution in terms of osmoles of solute per kilogram of solvent.

os·mo·lal·i·ty
n.
 of greater than 1,000. These qualities make D50 a caustic drug. Bear these facts in mind the next time that you need to give D50 to your patient; and administer the medication through a central line or through a running IV peripherally.

Lastly, remember that an ampule ampule /am·pule/ (am´pul) a small glass or plastic container capable of being sealed so as to preserve its contents in a sterile condition; used principally for sterile parenteral solutions.  of D50 will increase the blood glucose by 200. Therefore careful monitoring should be done to assure that the patient doesn't rebound from the D50 and end up with a low blood sugar once again.

References:

Drug label information: http://dailymed.nlm.nih.gov/ dailymed/drugInfo.cfm?id=1600

Moore, C. & Woollard, M. (2005). Dextrose 10% or 50% in the treatment of hypoglycaemia out of hospital? A randomised Adj. 1. randomised - set up or distributed in a deliberately random way
randomized

irregular - contrary to rule or accepted order or general practice; "irregular hiring practices"
 controlled trial. Emergency Medical Journal, 22: 512-5.

David W. Woodruff, MSN, RN, CNS See Continuous net settlement.

CNS

See continuous net settlement (CNS).
, CEN www. Ed4Nurses.com, reprinted with permission.
COPYRIGHT 2008 Nevada Nurses Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
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Title Annotation:News You Can Use; dextrose 50%
Author:Woodruff, David W.
Publication:Nevada RNformation
Article Type:Brief article
Geographic Code:1USA
Date:Aug 1, 2008
Words:240
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