Test 2 Parenteral Nutrition Flashcards
1
Q
Why don’t we start with the full % of dextrose that we want?
A
it will give the pt hyperglycemia because the endogenous insulin hasn’t been able to keep up yet
2
Q
How do we reach the level of dextrose that we want?
A
increasing in increments of 2-2.5% as pt tolerates
3
Q
Maximum dextrose %
A
- PIV: 12.5%
- Central: 25-30%
4
Q
dextrose nutritional contribution
A
3.4kcal/gram
5
Q
amino acids nutritional contribution
A
4kcal/gram
6
Q
lipid nutritional contribution
A
- 10kcal/gram
- for 10%: 1.1kcal/mL
- for 20%: 2kcal/mL
- for 30%: 3kcal/mL
7
Q
initiation of lipids
A
- 0.5-1 gram/kg/day
8
Q
Distribution of calories with protein
A
- Dextrose: 40-60%
- Amino acids: 7-15%
- Lipidsi: 30-50%
9
Q
Distribution of calories without protein
A
- Dextrose: 50-70%
- Lipids: 30-50%
10
Q
Phosphorous amount in KPhos
A
0.68mmol phosphate
11
Q
Phosphorous amount in NaPhos
A
0.75mmol phosphate
12
Q
Problem with calcium / phosphorous stability
A
- precipitation can occur
- calcium gluconate more stable
- add phosphate salts early; add calcium at end
- limit amount of Ca/Phos due to osteopenia
13
Q
formulations of sodium
A
- Sodium Chloride (NaCl)
- Sodium Acetate (NaAc)
- Sodium Phosphate (NaPhos)
14
Q
formulations of potassium
A
- Potassium Chloride (KCl)
- Potassium Acetate (KAc)
- Potassium Phosphate (KPhos)
15
Q
formulations of calcium
A
Calcium Gluconate
