Question

DATE HOME HEALTH TPN FORMULA: Patient Additives: mL D 8.5% 10% ロ55% WITH STANDARD ELECTROLYTES DEXTROSE: O 10% □20% 40% AMINO ACIDS. 425 357 125 | |□ MVC 9-3 10mL Daly HUMULIN-R10 times weekly times weekdy ml. 50% M 70s Runits DAILY - check one a 10% 20% mg mL □ □ FOLIC ACID LİPIDs: FOR ALL IN ONE FORMIULA VITAMIN K mg □ ㅡㅡㅡㅡㅡㅡ FINAL VOLUME □ OTHER: qsad STERLE WATER FOR INJECTION □ OTHER: 0.465 mEoml 5 mEq Calcium Gluconate Magnesium Suitate Potassiun Acetate Potassium Chloride Potassium Phosphate Sodium Acetate Sodium Chloride Sodium Phosphate TRACE ELEMENTS CONCENTRATE mEq Directions: mEq 2 mEq/mL 2 mEq/m 3 mwmt. 2 mEq/ml 4 mEq/ml DAILY INFUSE: ___ TIMES WEEKLY 22 mM | | OTHER DIRECTIONS: 35 mEq CONTINUOUS INFUSION: AT -mL PER HOUR CYCLIC INFUSION: OVER TAPER UP AND DOW Rate: STANDARD RATE: 110 mL PER HOUR HOURS AT FOR 12 VALIDATION LAB ORDERS STANDARD LAB ORDERS SMAC-20, CO2, Mg+2 TWICE WEEKLY CBC WITH AUTO DIFF WEEKLY UNTIL STABLE, THEN: SMAC-20, CO2, Mg + 2 WEEKLY CBC WITH AUTO DIFF MONTHLY DOCTORS SIGNATURE Print Name: Office Address: OTHER Phone: WHITE: Home Health mple caiculation in Figure 108. Sample physician's order form for TPN exa FIGURE 10-10

Use figure 10-10 to answer questions.

What are the total grams per bag of:

a. Amino acids (AA)

b. Dextrose

c. Lipids

Answer 1

1. Protein Content Calculations

¨To calculate the grams of protein supplied by a TPN solution, multiply the total volume of amino acid solution (in ml*) supplied in a day by the amino acid concentration.

Example Protein Calculation

¨1000 ml of 8% amino acids:

¨ 1000 ml x 8 g/100 ml = 80g

¨Or 1000 x .08 = 80 g

here

425 ml of 10% amino acid

425ml x 10g/100 ml

425ml x 0,10ml= 42.50 Avg. 40g

2. Dextrose Calculation

¨1000 ml of D50W (50% dextrose)

– 1000 ml x 50g / 100 ml = 500g dextrose

–OR 1000 ml x .50 = 500g dextrose

500g dextrose x 3.4 kcal/g = 1700 kcal

here

357ml of 70% dextrose

357ml x 70g/100ml

357ml x 0.70= 249.90 Avg- 250g Dextrose

3. Lipid Calculation

¨To determine kcalories supplied by lipid*, multiply the volume of 10% lipid (in ml) by 1.1; multiply the volume of 20% lipid (in ml) by 2.0.

¨If lipids are not given daily, divide total kcalories supplied by fat in one week by 7 to get an estimate of the average fat kcalories per day.

*|Lipid emulsions contain glycerol, so lipid emulsion does not have 9 kcal per gram as it would if it were pure fat. Some use 10 kcal/gm for lipid emulsions

¨500 ml of 10% lipid

–500 ml x 1.1 kcal/ml = 550 kcal

¨500 ml 20% lipid

–500 ml x 2.0 kcal/ml = 1000 kcal

here

125ml of 20% lipid.

in 100 ml - 20g lipid

so in 125ml - 25g lipid

125ml x 2 kcal/ml= 250 kcal