Exam 3 Lab Values Flashcards
Prealbumin
15-40
C-Reactive Protein
-Normal < 1
-Prealbumin decreases as CRP increases then it is inflammation
-Prealbumin decrease as CRP is normal then it is malnutrition
Total calories in a TPN
25-30 kcals/kg/day
Total protein in a TPN
-1-1.5 g/kg/day (floor patients)
-1.5-2 g/kg/day (ICU patients)
Ratio of non-protein calories
-70% carbs:30% fat
-100% carbs in sepsis patients
1g of protein in calories
4 kcals
Max carb intake
4-5 mg/kg/min
1g dextrose in calories
3.4 kcal
Max lipid intake
2.5 g/kg/day
1g lipids in calories
10 kcal
Calories in propofol
1.1 kcal/ml
How much trace element in TPN?
1 mL
How much multivitamin in TPN?
10 mL
1 mMol of phos in mEq
1.4 mEq
Normal RQ
0.85-0.95
Goal nitrogen
+3 to +5
Total TPN or MIVF volume
30-40 mL/kg/day
Refeeding syndrome effects
-Hypomagnesemia
-Hypokalemia
-Hypophosphatemia
How to prevent refeeding syndrome
-Limit carbs to 100-150g
-Limit fluids to 800 ml/day
-Give electrolytes
-Give 50% of caloric needs
-Give thiamine 100mg daily 5-7x
-Increase by 20-33% of goal every 1-2 days as tolerated
How much of daily calories is fatty acids?
4-10%
Onset of essential fatty acid deficiency
10-14 days
How to prevent essential fatty acid deficiency
-500 mL of 10% fat emulsion twice weekly over 3-5 hours
-250 mL of 20% fat emulsion twice weekly over 5-9 hours
Cholecalciferol IU to mCg
400 IU = 10 mCg
Calories of breast milk
20 Kcal
What increase drug distribution into breast milk?
-Non-ionized
-Small molecular weight
-Low protein binding
-High lipid solubility
-Long half life
-Low Vd
Premature neonates cholecalciferol dosing
-less than 1.5kg: 200 IU daily
-more than 1.5kg: 200-400 IU daily
Term infants cholecalciferol dosing for breastfed
400 IU daily
Formula fed term infants cholecalciferol dosing
200-400 IU daily until receiving 1000 mL/formula/day
Iron dosing for premature neonates
2 mg/kg/day
Iron dosing for term infants
3 mg/kg/day when deficient
Common ferrous sulfate oral solution concentration
75 mg/mL = 15 mg elemental iron/mL
Holliday-Segar Method for calculating fluid requirements less than 10kg
100 mL/kg
Holliday-Segar Method for calculating fluid requirements 10-20kg
1000mL + 50mL/kg for every kg over 10
Holliday-Segar Method for calculating fluid requirements over 20kg
1500mL + 20mL/kg for every kg greater than 20
UFH dosing
5000 U SQ q8h or q12h (possibly 7500U SQ q12h)
Enoxaparin dosing
-30 mg SQ q12h, 40mg SQ q24h
-CrCl <30 mL/min: 30 mg SQ q24h
Normal PCO2
40
Normal bicarb
24
Henderson-Hasselbach equation
pH = pKa +log(HCO3/0.03*pCO2)
Anion gap equation
Na - (Cl + HCO3)
Delta gap equation
Normal anion gap - current ion gap
Bicarb dose equation
((0.5 * IBW)(12 - actual bicarb))(0.33-0.5)
Dose of bicarb for chronic metabolic acidosis
1-3 mEq/kg/day
Urinary chloride of saline responsive alkalosis
less than 10-20
Urinary chloride of saline resistant alkalosis
More than 20
Normal Hgb
-13.5-18 male
-12-16 female
Normal MCV
80-100
Normal ferritin
-15-200
-Iron deficiency is less than 45
Normal TSAT
20-50%
Oral iron dosing
65mg of elemental iron every other day
Elemental iron in ferrous fumarate
100mg elemental iron in 300mg (33%)
Elemental iron in ferrous sulfate
65mg of elemental iron in 325mg (20%)
Elemental iron in ferrous gluconate
30mg of elemental iron in 300mg (10%)
Low serum B12
Less than 200
IM/SC B12 dosing
100-1000 mcg daily for 1-2 weeks, then weekly or monthly as maintenance
Oral B12 dosing
1000-2000mcg/day
Low serum folate
Less than 5
Oral folic acid dosing
1-5mg daily until Hgb normalizes
Final dextrose osmolarity in TPN
Less than 900