60-year-old male with an acute ileus s/p surgery for mesenteric ischemia. His height is 5’ 10’...
60-year-old male with an acute ileus s/p surgery for mesenteric ischemia. His height is 5’ 10’ and weight 160 lbs. Nutrition labs upon admission were WNL. His physician has ordered central TPN:
You will be using a 2-n-1 with initial stocks D50, AA11 and 20% lipid emulsion
- estimate Mr. H’s needs fluid, kcals, protein
- Determine your macro kcals/grams
- Do we need to calculate osmolarity?
- What is your lipid rate?
- What is your TPN rate for the 2-n-1?
- What is your glucose infusion rate?
- What is your final concentration of dextrose and amino acids?
- How would you write your order?
Homework Answers
- Estimate Mr. H’s needs fluid, kcals, protein
Fluids:2.3 lit/ Day
Kcals: 1800 calories/Day
Protein: 93g / 370 calories/Day
- Determine your macro kcals/grams
Macro Kcals
Carbohydrate: 925 Kcal / 231g (228-330 g)/ day
Protein : 370 Kcal / 93 g (51-178 g) / Day
Fat : 555 Kcal / 62 g (45- 79 g) /Day
- Do we need to calculate osmolarity?
Osmolarity will be calculated to measure the osmoles, osmolarity “r” is defined as the number of osmoles of solute per liter (L) of solution (osmol/L or Osm/L)
It will be calculated with the help of laboratory (or) clinical values.
- What is your lipid rate?
Body Fat: BMI method: - 25%
- What is your TPN rate for the 2-n-1?
Nutrient component for 2 in 1 is 2000 ml
Total calories – 1900 Kcal
Amino acids – 100 g
Glucose – 500 g
- What is your glucose infusion rate?
Glucose infusion rate: 1.4 mg/kg/min
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60-year-old male with an acute ileus s/p surgery for mesenteric
ischemia. His height is 5’ 10’...
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~parenteral nutrition
Case 2: Mr. His a 60 year old male with an acute ileus s/p surgery for mesenteric ischemia. His height is 5' 10' and weight 160 lbs. Nutrition labs upon admission were WNL His physician has ordered the following peripheral parenteral nutrition order: 10% Dextrose 3 amino acids at 90 cc per hour with 500 ml of 10% lipids a 24 hrs. 1. Calculate Mr. H's energy, protein and fluid needs....
3. Karol is a 38-year old White female experiencing severe GI complications and intractable N/V/D for the past three weeks post-op. Patient underwent bariatric surgery one month prior to developing these symptoms. Her surgeon orders a nutrition consult for total parenteral nutrition (TPN) orders after recent PICC line placement. Height: 5'6" Weight: 226 lb. UBW: 270 lb. Pertinent Labs: K+ - 3.3; Na - 149; Glucose - 83; Albumin - 2.6 Pertinent Meds: Daily MVI, Aspirin, Vitamin B12, 10,000 mcg...
Ricardo is a 36 year old African American male who had a recent colonoscopy due to paternal history of colon cancer in his immediate family. He was re-admitted into the surgical ICU of the hospital for a medical error made during his colonoscopy. During the procedure, the gastroenterologist accidently punctured his colon. This left him very septic with intractable nausea and vomiting. At 5'11", his pre-colonoscopy admission weight was 181 lb. and was re- admitted into the surgical ICU two...
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ase Bertha is a 65 year old Caucasian female with an admission height of 5'4" and weight of 135 lb. was admitted with a severe episode of CVA. Considering that her recent CVA affected her speech, she was unable to communicate her weight and diet intake history to the admitting nurse. Within 24 hours, her attending primary care physician placed orders for a complete metabolic panel, Mechanical Soft/Cardiac Diet, speech consult, and nutrition consult. Upon completion of the speech pathology...
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Case 1 Bertha is a 65 year old Caucasian female with an admission height of 5'4" and weight of 135 lb. was admitted with a severe episode of CVA. Considering that her recent CVA affected her speech, she was unable to communicate her weight and diet intake history to the admitting nurse. Within 24 hours, her attending primary care physician placed orders for a complete metabolic panel, Mechanical Soft/Cardiac Diet, speech consult,...
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