Question

PN Case Study 1

Joe is a 61 year old male, admitted with a complete obstruction of the small bowel due to a tumor. He went to the OR for resection of his jejunum and proximal ileum and a triple lumen catheter was placed. Joe is POD#5. He has an NGT draining 1500 ml per day.

Joe has IVF of D5 1/2NS w/20 mEq Kcl running at 150 ml/hr. Ht is 5’10”. Wt is 145#. Joe has lost 30# in past 6 mos

Labs: WBC 14.2, Hgb 14.0, Hct 39.9%, Plts 160
Na 136, K 3.6, HCO3 30, BUN 12, Cre 0.9, Glu 155, Alb 2.1 Mg 1.8, Phos 2.4, Ca 7.9, AST/ALT normal

Calculate Energy, Protein, Fluid needs and write Day 1 PN. Use a 3:1 PN solution to order PN.

Answer 1

#. Weight - 145lbs = 65.2kg

Height - 1.77m

Age - 61years

Formula for calculating energy:-

BEE = 293 − 3.8 × age (years) + 456.4 × height (meters) + 10.12 × weight (kg)

= 29.3- 3.8×61years+456.4×1.77m+ 10.12× 65.2kg

= 1528.1kcal

#. Protein requirement :-

Weight × 0.8gm

= 521.6gm

#. Fluid requirment :-

• For > 20 kg = 1500 mL + [weight (kg) x 20 ml/kg/day]
• = 1500ml+ 1220ml = 2720ml