You are giving dextrose 50% to a patient peripherally IV, all are complications you have to seen, EXCEPT?

AIIMS Rishikesh & Jodhpur NO - 2017

Medical & Surgical Nursing

Hard

Appeared in: AIIMS Rishikesh & Jodhpur NO - 2017

Explanation

Renal failure is not a direct or common complication associated with the peripheral IV administration of Dextrose 50%.
The primary components of D50W (dextrose and water) are metabolized by the body and do not have a direct nephrotoxic (kidney-damaging) effect.
While severe, prolonged hyperglycemia can eventually lead to kidney damage (diabetic nephropathy) or acute kidney injury from dehydration in a hyperosmolar hyperglycemic state (HHS), this is an indirect and long-term consequence, not an immediate complication of the infusion itself.

Option A: Edema (swelling) is a classic sign of IV infiltration or extravasation, where the IV fluid leaks into the surrounding tissue. This is a known risk with any IV, but especially with irritating solutions like D50W.
Option C: Hyperglycemia (high blood sugar) is a direct systemic complication. Dextrose 50% is a highly concentrated sugar solution, and administering it can easily raise blood glucose levels above the normal range.
Option D: Thrombophlebitis (inflammation of a vein with clot formation) is a common local complication. Hypertonic solutions like D50W are known to irritate the inner lining of peripheral veins, leading to this condition.

Clinical Relevance

Nursing practice connection: Use the key finding related to Complications of administering hypertonic solutions via peripheral IV to guide bedside assessment, documentation, and the next nursing action.
Nurses must frequently assess peripheral IV sites for signs of complications, especially when infusing hypertonic or vesicant drugs. The Infusion Nurses Society (INS) provides standardized scales for grading infiltration and phlebitis.
Due to the high risk of thrombophlebitis and tissue damage from extravasation, Dextrose 50% should ideally be administered through a large, central vein if possible, especially for repeated doses.
Patient safety requires vigilant monitoring of both the IV site (for local complications) and the patient's blood glucose levels (for systemic complications like hyperglycemia).

How to Approach the Question

First, identify the core of the question: it asks for the EXCEPTION among a list of complications for a specific procedure (peripheral IV Dextrose 50%).
Analyze the drug and route: Dextrose 50% is a hypertonic, irritating solution given into a small peripheral vein.
Consider the properties of the drug. It's highly concentrated sugar. This immediately suggests hyperglycemia is a risk.
Consider the properties of the route. A highly irritating fluid in a small vein suggests local vein damage is likely. This points to thrombophlebitis and infiltration (which causes edema).
Evaluate each option: Edema (from infiltration), Hyperglycemia (from sugar load), and Thrombophlebitis (from vein irritation) are all plausible, direct complications.
The remaining option, Renal failure, is not a direct, immediate effect of dextrose. Therefore, it is the correct answer to the 'EXCEPT' question.

Concept Tested & Keywords

Concept Tested: Complications of administering hypertonic solutions via peripheral IV.
Stem keywords: dextrose 50%, peripherally IV, complications
Lead-in keywords: EXCEPT
Negative lead-in flag: Question asks for the exception.

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E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 73-75

E6 Nursing Fundamentals Taylor p. 801-803