DUE FEBRUARY 23, 2013
EXAMPLE A
Dextrose 20% and AA 3% @ 55ml/hr(std. electrolytes, MVI, and Trace elements) over 24hrs.
20% Lipids 500ml daily. The patient weight 72kg
1a. How many calories are provided from fat? 1000kcal
2a. How many grams of carbohydrate (dextrose) per day does this TPN provide? 264grams
3a. How many grams of amino acids (protein) per day does this TPN provide? 39.6grams
4a. How many calories are provided by the amino acids? 160kcal/day
5a. How many TOTAL calories does this TPN provide daily? 2,056kcal
6a. What is the glucose utilization rate for this patient? 2.54mg/kg/min
7a. What is the estimated osmolality? @1500mOsm
8a. Is this a Central or peripheral nutrition solution? Central
9a. How much volume of 70% dextrose stock does did it require to make the above TPN? 377ml
10a. How much volume of 10%AA stock did it require to make the above TPN? 400ml
Patient requirements:
11a. Calories:
21kcal/kg/day = _1512____kcal/day
12a. Amino acids: 1.3g/kg/day = __93____g/day
13a. Does the above TPN meet the patients needs? Yes/No, If no – why not: Excess calories
&__Insufficient AA
EXAMPLE B
Dextrose 10% and AA 5% @ 75ml/hr(std. electrolytes, MVI, and Trace elements) over 24hrs.
20% Lipids 250ml daily. The patient weight 42kg
1b. How many calories are provided from fat? 500kcal
2b. How many grams of carbohydrate (dextrose) per day does this TPN provide? 180grams
3b. How many grams of amino acids (protein) per day does this TPN provide? 90grams
4b. How many calories are provided by the amino acids? 360kcal/day
5b. How many TOTAL calories does this TPN provide daily? 1,472kcal
6b. What is the glucose utilization rate for ST? 2.97mg/kg/min
7b. What is the estimated osmolality? @1200mOsm
8b. Is this a Central or peripheral nutrition solution? Central
9b.How much volume of 50% dextrose stock does did it require to make the above TPN? 360ml
10b. How much volume of 15%AA stock did it require to make the above TPN? 600ml
Patient requirements:
11b. Calories:
35kcal/kg/day = _1470______kcal/day
12b. Amino acids: 2.1g/kg/day = __88__g/day
13b. Does the above meet the patients needs? Yes/No, If no – why not: __PERFECT!_
EXAMPLE C
Dextrose 25% and AA 6% @ 95ml/hr(std. electrolytes, MVI, and Trace elements) over 18hrs.
20% Lipids 250ml daily. The patient weight 48kg
1c. How many calories are provided from fat? 500kcal
2c. How many grams of carbohydrate (dextrose) per day does this TPN provide? 427.5grams
3c. How many grams of amino acids (protein) per day does this TPN provide? 102.6grams
4c. How many calories are provided by the amino acids? 410kcal/day
5c. How many TOTAL calories does this TPN provide daily? 2,364kcal
6c. What is the glucose utilization rate for ST? 8.23mg/kg/min
7c. What is the estimated osmolality? @2050mOsm
8c. I s this a Central or peripheral nutrition solution? Central
9c. How much volume of 70% dextrose stock does did it require to make the above TPN? 611ml
10c. How much volume of 15%AA stock did it require to make the above TPN? 684ml
Patient requirements:
11c. Calories:
27kcal/kg/day = _____1296____kcal/day
12c. Amino acids: 1.5g/kg/day = __72____g/day
13c. Does the above meet the patients needs: Yes/No, If no – why not: _Drastically overfeeds
both calories and amino acids
Example #4
MANY POSSIBLITLIES:
These are two options
Create a TPN that provides @ 105grams of amino acids and 2200total kcal/day
Provide:
Dextrose
___20_____%
Amino acid ____5.5____%
Lipids
_20______% volume ___250____ml/day
TPN rate
__95_____ml/hr over ____20____hr/day
2210Kcal, 104.5g/day, 380g CHO
Provide:
Dextrose
___20_____%
Amino acid ____6____%
Lipids
_20______% volume ___250____ml/day
TPN rate
__75_____ml/hr over ____24____hr/day
2156Kcal, 108g/day, 360g CHO