A nurse is caring for a client who is diagnosed with severe diarrhoea with dehydration and is receiving 500 ml dextrose 10% intravenously (IV). How much calorie will get the patient from 500 ml dextrose 10% IV fluid?

Appeared in: NORCET -4 , 2023

Explanation

A 10% dextrose solution means there are 10 grams of dextrose in every 100 mL of the solution.
For a 500 mL infusion, the total amount of dextrose is calculated as (10 g / 100 mL) * 500 mL = 50 grams.
Using the standard simplified caloric value for carbohydrates in a clinical context, each gram of dextrose provides 4 kilocalories (kcal).
Therefore, the total calories provided are 50 grams multiplied by 4 kcal/gram, which equals 200 kcal.

Option B: This value is too low. 100 kcal would be provided by 25 grams of dextrose.
Option C: This value is too high. 300 kcal would require 75 grams of dextrose.
Option D: This value is too high. 400 kcal would require 100 grams of dextrose.

Visual 1: Infographic: A step-by-step visual guide to calculating calories from a D10W IV bag, showing the conversion from mL to grams to kcal. .

Clinical Relevance

Nursing practice connection: Use the key finding related to Calorie calculation for intravenous dextrose solutions to guide bedside assessment, documentation, and the next nursing action.
Administering hypertonic solutions like D10W requires careful monitoring of the IV site for phlebitis and infiltration, as it can cause significant tissue damage.
Dextrose infusions can lead to hyperglycemia, especially in patients with impaired glucose tolerance or those under metabolic stress. Regular blood glucose monitoring is an essential nursing intervention.
What if the patient was receiving 500 mL of D5W instead? The caloric intake would be halved to 100 kcal (25g x 4 kcal/g), demonstrating how concentration directly impacts nutritional support.

How to Approach the Question

First, identify the key values given in the question: the total volume of the fluid (500 ml) and the concentration of the solution (dextrose 10%).
Second, interpret the percentage concentration. '10%' means 10 grams of the substance (dextrose) per 100 mL of solution.
Third, calculate the total mass of dextrose in the entire volume. Set up a proportion: (10 grams / 100 mL) = (X grams / 500 mL). Solve for X to find the total grams.
Fourth, recall the standard caloric value for carbohydrates used in nursing calculations, which is 4 kcal per gram.
Fifth, multiply the total grams of dextrose by this caloric value to find the total calories.
Finally, compare your calculated answer with the given options to select the correct one.

Concept Tested & Keywords

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Practise the full NORCET -4 , 2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.