Question

DIRECTIONS: Reflect upon the calculation lectures received during your dosage from courses, and Professional Practice III. Consider the following TPN medication order (Table 1) and the Stock Solutions (Table 2); then determine the exact volume of cach component that should be used to compound the preparation. Round to the nearest whole mL. Answers will be incorrect if not appropriately rounded. To receive all credit, show all work. This assignment can be typed or handwritten, but all work must be shown. Upload document to Moodle under Assignment # 4. TABLE 1 TABLE 2 Pharmacy, Stock Solutions Adult Total Parenteral Nutrition Central Line Amino Acid 15 % 70 % Total TPN Volume : (please Dextrose supply) (1pt) Qs with H20: supply) (1pt) To make 2500mL + 100mL overfill. Rate: 20% 4mEg/ml Na= 4mEq/ml PO4= 3mM/mL IV Fat Emulsion Sodium Chloride Sodium Phosphate (please mL/hr (please supply rate for a 24 hour period) (2pts) Potassium Chloride 2 mEg/ml 4.06 mEg/ml, 10 mL Magnesium Sulfate 50% Grams of Protein 50 30 250 0.47 mEg/ml Calcium Gluconate Grams of Lipid Grams of Dextrose 10% MTE-5 10 ml 10 ml MVI Central Additives Calcium Gluconate Magnesium Sulfate Potassium Chloride Sodium Chloride Sodium Phosphate MVI 2 mg/ml Phytonadione 5.2 mEg 1.5G 30 mEg 60 mEg 10 mM 15 mL/day 1500 mcg/day 5 mL/day Vitamin K Trace Elements -5 1. Amino Acid= ml (1pt) ml (1pt) 2. Magnesium Sulfate= 4. Calcium Gluconate= ml (1pt) 3. Dextrose= ml (1pt) 6. Potassium Phosphate= ml (2pts) ml (2pts) 5. IV Fat Emulsion 20 %= 7. Sodium Chloride= ml (2pts) 8. Vitamin K (Phytonadione)= ml (2pt) ml (2pts) 9. Potassium Chloride= 10. Total mEq of sodium in TPN solution= mEq (4pt)

Answer 1

Consider the following TPN order with the stock solution

Answer:

1. Amino acid

As per table 1, The required protein is 50gm.

The stock contains 15%

Hence, Amino acid = 50 x 15 = 750mL

Amino acid = 750mL

2. Magnesium sulfate

As per table1, the required solution of magnesium sulphate is 1.5 gm or 1500mg

The stock solution contains mgS04 in mEq

To convert into mEq = mg / atomic weight x valence

MgSo4 = 1500mg

Atomic weight of mgSo4 = 24.3

valence = 2

mEq = 1500 / 24.3 x 2

= 123.4567

Required amount of mgSo4 = 123.4567 mEq

Available in stock solution = 4.06 mEq

So mgSo4 = 123.4567 / 4.06

mgSo4 = 30.40mL

Magnesium sulphate = 30mL

3. Dextrose

As per table 1, dextrose needs 250grams

Table 2 contains 70% dextrose

So the required amount of dextrose = 250 x 70 / 100

= 175mL.

Dextrose = 175mL.

4. Calcium gluconate

As per table 1, calcium gluconate needs 5.2mEq

Available stock solution is 0.47mEq

Required Calcium gluconate = 5.2 / 0.47

= 11.06mL

Calcium Gluconate = 11mL

5. IV Fat emulsion

As per TPN 30 grams of lipid is required

Stock solution contains 20% fat

Required Fat emulsion = 30 x 20

= 600mL

IV Fat solution 20% = 600mL

6. sodiumphosphate

Required for TPN = 10mM

Available = 3mM / mL

Required amount in mL = 10/3 = 3.333

Sodium Phosphate = 3mL.

7. Sodium chloride

REquired amount = 60mEq

Available in stock = 4mEq/mL

Required amount in mL = 60 / 4 = 15mL

Sodium chloride = 15mL.

8. Vitamin K

Required amount = 1500mcg/day.

= 1.5mg/day

Available in stock = 2mg /mL

Required amount in mL = 1.5/2

= 0.75mL

Vitamin K = 0.75mL

9. Potassium chloride

Required amount for TPN = 30mEq

Available in stock solution = 2mEq/mL

Required amount in mL = 30/2

= 15mL

Potassium chloride = 15mL.

10. Total mEq of sodium in TPN solution

sodium chloride + sodium phosphate = 60 + 10

Total mEq of sodium in TPN solution = 70 mEq

Total TPN = 7.5 +30 +175 +11 +6 +3 +15 +0.75 +15 = 263.25