Question

RK is a 154 lb female with Hyperemesis Gravidarum [average daily emesis = 750ml] who has...

RK is a 154 lb female with Hyperemesis Gravidarum [average daily emesis = 750ml] who has been ordered the following:

TPN @ 25Kcal/kg: 30% Kcal from Lipids, 1gm/kg from amino acids and the balance of calories from dextrose.

How would the pharmacist design the above TPN using 10% amino acids, 50% dextrose, 20% lipids and sterile water for injection? Using standards of care for pregnant patients [per Practical Gastroenterology-June 2008], fluid requirements during pregnancy are 30ml/kg plus an additional volume to replace that which is lost daily via emesis.

1. Calculate the maximum daily fluid requirements _______________________________________

2. Calculate total Kcal ____________________________________________

3. Calculate Kcal from lipids __________________________________________ a. Calculate the volume of lipids ________________________________________ b. Calculate the grams of lipids ________________________________________

4. Calculate the grams of amino acids per day _______________________________ a. Calculate the volume of amino acids _______________________________ b. Calculate the Kcal of amino acids __________________________________

5. Calculate the Kcal from dextrose ____________________________________________ a. Calculate the grams of dextrose per day ____________________________________ b. Calculate the volume of dextrose per day ____________________________________

6. Calculate volume of sterile water to “qs” to total daily fluid requirements __________________________________________

7. Calculate the infusion rate (in ml/hr) if the TPN is to be infused over 24 hours ___________________________________________

Homework Answers

Answer #1

1lbs = 0.45 kg

154 lbs = 69.3 kg

1. Daily fluid requirement is 30 ml/kg + 750 ml (emisis loss)

So, 30*69.3 =2079+750 = 2829 ml

2. total calorie = 25kcal per kg = 25*69.3 =1732.5 kcal

3. calories from Lipids = 30% from lipid

total calories * 30/100= 1732.5*30/100 =519.75kcal

a, Volume of lipid = 20% of total solution= 2829*20/100=565.8ml

b grams of lipid = 30% of lipid in 565.8 ml =30*565.8/100 =169.74 gram

4. grams of amino acid per day

1 gm per kg = 1*69.3 = 69.3 gms of amino acid

a. volume of amino acid

b. calories of amino acid

4kcal/gm

69.3*4=277.2 kcal

5. calories from dextrose= total calories- amino acid calories-lipid calories

1732.5kcal-519.75kcal-277.2 kcal=935.55 kcal

a. Total kcal/3.4 kcal/gm= 935.55/3.4 kcal/gm=275.2 gms

b.

6.

7.infusion rate over 24 hrs= total volume/ 24 hr = 2829ml/24hrs =118 ml/hr

Know the answer?
Your Answer:

Post as a guest

Your Name:

What's your source?

Earn Coins

Coins can be redeemed for fabulous gifts.

Not the answer you're looking for?
Ask your own homework help question
Similar Questions
Answers are below WITH QUESTION MARK BESIDE IT - please show how to CALCULATE A patient...
Answers are below WITH QUESTION MARK BESIDE IT - please show how to CALCULATE A patient is receiving an intermittent tube feeding/bolus of 300cc formula, four times per day. The formula provides 1.5 kcal/cc and 795cc water/liter. The patient’s estimated daily fluid requirement is 1800cc/24 hours. How much additional water will be required per feeding? 1) 212cc per feeding ? 2) 101cc per feeding 3) 239cc per feeding 4) 199cc per feeding A TPN prescription consists of the following: 500ml...
1. A 12-year-old child is being treated for an intra-abdominal infection post appendectomy. The provider has...
1. A 12-year-old child is being treated for an intra-abdominal infection post appendectomy. The provider has ordered piperacillin and tazobactam (Zosyn) 200 mg/kg/day q 6 hours IV. The child weighs 98 pounds. How many mg per dose should the child receive? Round your final answer to the nearest whole number. 2. The Zosyn is supplied in a piggyback form containing the full dose in a 100ml bag and is to be infused over 1 hour. What rate do you set...
1- Chemotherapy may cause patients to experience GI problems because: a.The chemotherapy drug increases blood flow...
1- Chemotherapy may cause patients to experience GI problems because: a.The chemotherapy drug increases blood flow to the tumor b.The chemotherapy drug causes an allergic reaction c.The chemotherapy drug affects rapidly-dividing epithelial cells d.The chemotherapy drug is difficult to metabolize 2- The primary goal of medical nutrition therapy for cancer patients is: a.To ensure adequate intake of fluids b.To ensure adequate micronutrient intake c.To prevent cachexia D. To increase body weight 3- Which of the following nutrient recommendations for HIV...
ADVERTISEMENT
Need Online Homework Help?

Get Answers For Free
Most questions answered within 1 hours.

Ask a Question
ADVERTISEMENT