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Flashcards in TPN Deck (13)
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1
Q

Dextrose

  • Provides
  • Max dose:
A
  • Provides: 3.4 cal/gram

- Max: 500g/day in adults

2
Q

Prolonged TPN contains

  • Glutamine:
  • Choline:
A
  • Glutamine: protects gut epithelia lining

- Choline: protects liver from hepatic fat deposits

3
Q

Minimum daily requires for protein

A

1.0 - 1.5g/kg/day

4
Q

Alpha linoleic

A

Omega-3

5
Q

Lineloic acid

A

Omega-6

6
Q

Fat provides

  • 1g of PO fat:
  • 1g of IV fat emulsion
A
  • 1g of PO fat: 9 cal

- 1g of IV fat emulsion: 10 cal

7
Q

Fat emulsion calories

10%:
20%:
30%:

A
10% = 1.1 cal/mL
20% = 2.0 cal/mL
30% = 3 cal/mL
8
Q

TPN electrolytes

  • Never add HCO3
  • Never add extra Ca
  • Add ? first and last
A
  • Never add HCO3: It ppt Ca++
  • Never add extra Ca: It ppt PO4

=> First add PHOSphate then Last add Calcium

9
Q

Trace element include

A
  • Copper, Chromium, Cobalt
  • Iron, Iodine, Fluride
  • Manganese, Molybdenum
  • Zinc, Selenium

=> Mixing iron w/ lipids cracks the emulsion => give separately or in TPN w/o lipids

10
Q

Vit

  • MVI -12
  • MVI -13:
A
  • MVI -12: Has all it except Vit K

- MVI -13 and Ped MVI have Vit K

11
Q

Filters from TPN

A
  • Dextrose and protein TPN: 0.22 micron filter

- Lipid emulsion: 1.2 micron filter

12
Q

Monitors

A
  • LFT
  • Electrolytes
  • Renal function
  • Pre-albumin
  • PT/PTT
  • Nitrogen Balance
13
Q

Nitrogen Balance (NB)

  • Nitrogen intake
  • Nitrogen loss
  • Positive NB
  • Negative NB
A
  • Nitro intake: Daily protein intake/6.25
  • Nitro loss: Daily protein in 24H urine + 4
  • Positive: is our goal; anabolic state
  • Negative: muscle wasting and weight loss