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IV fluids
DNS : We commonly infuse DNS - Dextrose Normal Saline - in collapsible bag or bottle
The label is as follows :
DNS
Sterile, non-pyrogenic single dose plastic container
SODIUM CHLORIDE (0.9% W/V) AND
DEXTROSE (5% W/V) INJECTION IP
Each 100 ml contains
Dextrose anhydrous IP 5 . 00 gm
Sodium Chloride IP 0.9 gm
Water for injection IP qs
mmol/L Na+150 Cl- 150
KCal : 170
Dextrose 50 gm / L
Caution : Even invisible damage to the bottle during transit, storage or handling may result in contamination.Do not use if the container is found leaking upon squeezing or if the solution is not clear. solutions containing visible solid particles should not be used
Manufactured by .....
Dosage : As directed by the physician.
To be used with non pyrogenic
I.V. administration set with aseptic technique.
For I.V. use only.
Store in a cool, dark place, protected from light.
M.L. No. : G/28/LVP/8
Max.Retail Price Rs : 17.68
B.No. : 303110325
Mfg. Dt. : JUN - 2008
Exp.Dt. : MAY - 2011
Sterile = free of microorganisms (sterilized)
Non-pyrogenic = Not producing fever (pyrexia)
Plastic container : the bottle is made of soft plastic. It collapses or becomes flattened as the fluid in it goes out. There will be no space as the bottle empties. So there will be no air nor any vacuam. Since there will be no air no danger of air entering the vein; since there is no vacuam there is no necessity for any airway while infusing the fluid.
Most people insert a needle at the top, while infusing fluid which is a wrong practice. At times of emergency we cannot squeeze the bottle and increase the rate of infusion because the holes made at the top by the needle will allow the fluid to leak out and thereby prevent quick infusion.
Sodium Chloride = NaCl = common salt
0.9 % W/V = 0.9 gm salt in 100 ml of water; weight/volume
What is 1 % solution?
1 % solution is one gram solute (substance which is dissolved in the liquid)
in
100 ml of solvent (the substance which dissolves the solute).
Each 100 ml contains : one bottle contains usually 500 ml; so, all the weights have to be multiplied by five to know the total weight of the substance in one bottle.
Total quatity of sodium chloride is = 0.9 X 5 = 4.5 gms
Total quantity of Dextrose anhydrous = 5 X 5 = 25 gms
In practice, one often measures an amount of the substance in a gram-mole, which is the quantity of a substance whose mass in grams is equal to its formula weight. Thus a gram-mole for Carbon is 12.01 grams, while for water it is 18.016 grams. The entity counted is usually an atom (as in C) or a molecule (as in H2O, molecular formula weight = 2 H atoms + 1 O atom ˜18).
In other words a mole is the atomic weight or molecular weight expressed in grams.
atomic weight of sodium = 22.989768
Dextrose or glucose is a simple carbohydrate.
Carbohydrates provide 4 Kilo calories per gram.
Each bottle of DNS contains 5 gm/ 100 ml X 500 ml) = 25 gms
So each bottle of DNS will provide 25 X 4 = 100 kilo calories
In the label it is written that it provides 170 Kilocalories / L
i.e. 170 / 2 for 500 ml; that is 85 kilocalories per bottle. Actually it has to be 100
What is requirement of salt for one day for a man?
Minimum requirement is 4 grams
How much is there in this bottle?
0.9 gm X 5 = 4.5 gms; enough salt for one day. (0.9 gms in 100 ml - for 500 ml : 0.9 X 5)
What is the calori requirement for a sedentary (resting) man?
1200 Kilocalories
How many kilocalories does this bottle contain?
100 Kilocalories - through the dextrose in it.
During maintenance therapy, we give only 5 or 6 bottles of dextrose. That will give around 500 to 600 kilocalories. But a sedentary man needs around 1200. What to do for the balance?
The balance of the calories are obtained from breakdown of the fat in the body. Usually patients can be sustained for nearly 20 - 30 days with just 100 calories. After that patient may need total parenteral nutrition i.e. nutrition through i.v.
to be continued ........
