IV Nutrition Formulation

Question 1

Vitamins =

Answer 1

yellowish color

Question 2

Lipids =

Answer 2

white color

Question 3

TPN has

Answer 3

all three macronutrients

Question 4

Need: 15% dextrose in 1680 mLs

How much dextrose is needed?

Answer 4

15 gm X gm
100 mL 1680 mL
X = 252 gm dextrose needed

Question 5

Start with D70 with 252 gm of dextrose

How much D70 do you need?

Answer 5

70g 252 g
100 mL X mL
X = 360 mL of D70

Question 6

Amino acid solutions for adults

Answer 6

Aminosyn
FreAmine
Novamine
Travasol

Question 7

Amino acid solutions for peds

Answer 7

Trophamine

Aminosyn PF

Question 8

Base solution concentrations of amino acid solutions are

Answer 8

3-15%

Question 9

Amino acid solution: 10%

Need 25 gm/d

Answer 9

25 g 10 g
X mL 100 mL
X= 250 mL of 10% AA soln

Question 10

Lipid Emulsions Options

Answer 10

10% (1.1 cal/mL)
20% (2 cal/mL)
30% (3 cal/mL)

Question 11

2 in 1 Formulations

Answer 11

Dextrose and AA
Flexibility in amount of aa and dextrose
See precipitation
In line filter to remove particles in solution
Less microbial growth

Question 12

3 in 1 Formulations

Answer 12

Decrease time to administer lipids separately

Question 13

Factors which help to stablizer Lipid Emulsions (3 in 1)

Answer 13

High pH >5.0
Low dextrose concentration 
Low protein concentration
Low amounts of divalent cations
Avoid use of trivalent cations
Add lipids LAST

Question 14

46.8 mEq NaCl ordered
3% stock solution NaCl
3% = 513 mEq/1 L = 0.513 mEq/mL
How many mL of NaCl?

Answer 14

46.9 mEq | 0.513 mE
X mL 1 mL
X = 91 mL NaCl

Question 15

Factors that enhance Ca:P Stability

Answer 15

Ca gluconate 
Low product ratio
Add P then Ca last
Refrigerate
Infuse within 24 hrs
Less than 6.0
High dextrose
Addition of l-cysteine
Amino acids

Question 16

Calcium Phosphate Ratio

Answer 16

Ca X P X 1.8 less than 300

Question 17

Neonatal TPN Calcium:Phosphorous Ratio (using trophamine)

Answer 17

Ca (mEq) X PO4 (mmol) / Vol (L) or

Ca (mg) * 0.0045 X PO4 (mEq) x 0.68 / vol (L)

Question 18

Neonatal TPN Calcium:Phosphorous Ratio (using trophamine) range

Answer 18

Less than 40 for neonatal TPN without cysteine

Less than 60 for a TPN with cysteine

Question 19

Vitamins added:

Answer 19

MVI-12
MVC 9+3
Vitamins A, B1/2/3/6/12, C, D, E, biotin, pantothenic acid, folic acid
Vit K if not on warfarin

Question 20

Standard trace element formulations

Answer 20

MTE4 MTES TEC4 PTE4

Question 21

Remove ____ for hepatic deficiency

Answer 21

Copper and manganese

Question 22

Remove _____ for renal failure

Answer 22

Selenium and chromium