Chapter 11: Calc III: Parenteral & Enteral Nutrition Flashcards
(60 cards)
1
Q
How much calories is provided by 1 gram of carbs given Enteral?
A
4kcal/gram
2
Q
How much calories is provided by 1 gram of carbs given parenterally?
A
3.4kcal/gram
3
Q
How much calories is provided by 1 gram of fat given Enterally?
A
9 kcal/gram
4
Q
How much calories is provided by 1 gram of protein given Enterally/Parenterally?
A
4 kcal/gram
5
Q
How much calories is provided by 1 gram of Glycerol/Glycerin given Parenterally?
A
4.3 kcal/gram
6
Q
How much calories is provided by Injectable Lipid Emulsion (ILE) 10% given Parenterally?
A
1.1 kcal/mL
7
Q
How much calories is provided by Injectable Lipid Emulsion (ILE) 20% given Parenterally?
A
2 kcal/mL
8
Q
How much calories is provided by Injectable Lipid Emulsion (ILE) 30% given Parenterally?
A
3 kcal/mL
9
Q
What are the 2 types of PN admixtures that are used?
A
2-in-1: Dextrose and Amino Acids
3-in-1: Dextrose, Amino Acids, Lipids
10
Q
What is the equation to help with calculating daily fluids?
A
1500 ml + (20ml)(weight kg - 20)
11
Q
- Calculate GG’s Daily Fluids for a 57 yo female weighing 65 kg.
A
2400 ml/day
12
Q
- What volume of fluid should a 76 yo, 154 pound patient receive per day?
A
2500 ml/day
13
Q
- Calculate the Basal Energy Expenditure for a 66 yo male with major trauma. (stress factor is 1.5). He weighs 174 pounds and is 5’10”.Activity factor is 1.2. Round to the nearest whole number.
BEE (males):
66.47 + 13.75(weight in kg) + 5(height in cm) - 6.76(age in years)
A
1597 kcal/day
14
Q
- Calculate the total energy expenditure for a major trauma patient.
A
2875 kcal/day
15
Q
- A 25-year-old female major trauma patient survives surgery and is recovering in the surgical intensive care unit.
The medical team wants to start PN therapy. She is 122 pounds, 5’7” with some mild renal impairment. Calculate
her BEE using the Harris-Benedict equation and her TEE (stress factor = 1.7 and activity factor = 1.2). Round each
to the nearest whole number.
A
BEE = 1385 kcal/day
TEE = 2825 kcal/day
16
Q
What are the Protein Requirements for Non-Hospitalized and Hospitalized individuals?
A
Non-Hospitalized: 0.8 - 1 g/kg/day
Hospitalized: 1.2 - 3 g/kg/day
17
Q
- MK is a 62-year-old female who has been admitted with enteritis and pneumonia. She has a history of Crohn’s disease and COPD. Her IBW is 54.7 kg. The staff gastroenterologist has ordered PN therapy with 1.5 g/kg IBW/day of protein. How many grams of protein will MK receive per day? Round your answer to the nearest whole number.
A
82 g protein/day
18
Q
- PP is a 46-year-old male who weighs 207 pounds. He is admitted for bowel resection surgery. Post surgery, he is to be started on PN therapy. The physician wants the patient to receive 1.3 g/kg/day of protein. Calculate his protein requirement. Round to the nearest whole number.
A
122 g protein/day
19
Q
How many grams of nitrogen are from protein?
A
1 g of nitrogen = 6.25 g of protein
20
Q
- Calculate the grams of nitrogen for a patient receiving 540 ml of 12.5% amino acid.
A
10.8 g of Nitrogen
21
Q
How to find the Non-protein calorie to Nitrogen Ratio?
A
Calculate grams of nitrogen per day
Divide the total non-protein (dextrose + lipids) by the grams of nitrogen
22
Q
What are the desirable ratios for NPC:N?
A
Most severely Stressed: 80:1
Severely Stressed: 100:1
Unstressed: 150:1
23
Q
- A patient is receiving PN containing 480 mL of dextrose 50% and 50 grams of amino acids plus electrolytes.
Calculate the non-protein calories to nitrogen ratio for this patient.
A
816:8 or 102:1
24
Q
What are some of the Amino Acid Brands and their strengths?
A
Aminosyn, FreAmine, Travasol, TrophAmine, Clinisol
5%, 8.5%, 10%, 15%
25
10. How many milliliters of Aminosyn 8.5% are needed to provide 108 g of protein?
1271 ml
26
11. How many calories are provided by 108 grams of protein?
432 kcal of protein
27
12. How many milliliters of FreAmine 10% are needed for 122 grams of protein?
1220 ml
28
13. JR is a 55-year-old male (weight 189 pounds) who is confined to bed (activity factor 1.2) due to his current infection (stress factor 1.5). JR requires 1.4 g/kg/day of protein and the pharmacy stocks Aminosyn 8.5%. Calculate the amount of Aminosyn, in milliliters, JR should receive. Round to the nearest whole number.
1415 ml
29
14. How many calories are provided by 97 grams of protein?
388 kcal of protein
30
15. A PN order is written to include 800 mL of 10% amino acid solution. The pharmacy only has 15% amino acid solution in stock. Using the 15% amino acid solution instead, how many milliliters should be added to the PN bag?
Round to the nearest whole number.
533 ml
31
16. Using 50% dextrose in water, how many milliliters are required to fulfill a PN order for 405 grams of dextrose?
810 ml
32
17. DE, a 44-year-old male, is receiving 1,235 mL of D30W, 1,010 mL of FreAmine 8.5%, 200 mL of Intralipid 20% and 50 mL of electrolytes/minerals in his PN. How many calories from dextrose is DF receiving from the PN? Round to the nearest whole number.
1260 kcal/day
33
18. A pharmacist mixed 200 mL D20% with 100 mL D5%. What is the percentage strength of dextrose in the final bag?
15% w/v
34
19. If a 50% dextrose injection provides 170 kcal in each 100 mL, how many milliliters of a 70% dextrose injection would provide the same caloric value? Round to the nearest tenth.
71.4 ml
35
20. How many calories does 640 ml of D50W provide?
1088 kcal
36
21. A PN order is written for 500 mL of 50% dextrose. The pharmacy only has D70W in stock. How many milliliters of D7OW should be added to the PN bag? Round to the nearest whole number.
357 mL
37
22. A patient is receiving 500 mL of 10% lipids. How many calories is the patient receiving from the lipids? Round to the nearest whole number.
550 kcal
38
23. The total energy expenditure (TEE) for a critically ill patient is 2,435 kcal/day. The patient is receiving 1,446 kcal from dextrose and 810 kcal from protein. In this critical care unit, clinicians do not include protein calories in the TEE estimation. How many kcal should be provided by the lipids?
989 kcal
39
24. Using 20% Smoflipid, how many milliliters are required to meet 989 calories? Round to the nearest whole number.
495 mL
40
25. A patient is receiving 660 mL of 10% Intralipid on Saturdays along with his normal daily PN therapy of 1,420 mL of D2OW, 450 mL Aminosyn 15%, and 30 mL of electrolytes. What is the daily amount of calories provided by the lipids? Round to the nearest whole number.
104 kcal/day
41
26. A patient is receiving 180 mL of 30% lipids. How many calories is the patient receiving from the lipids?
540 kcal
42
27. A PN order calls for 475 calories to be provided by lipids. The pharmacy has 10% lipid emulsion in stock. How many milliliters should be administered to the patient? Round to the nearest whole number.
432 mL
43
28. The pharmacist is going to add 80 mEq of sodium to the PN; half will be given as sodium acetate (2 mBq/mL.) and half as sodium chloride (4 mEq/mL). How many milliliters of sodium chloride will be needed?
10 mL
44
29. The pharmacist is making PN that needs to contain 80 mEq of sodium and 45 mEq of acetate. The available pharmacy stock solutions include sodium chloride (4 mEq/mL of sodium) and sodium acetate (2 mEg/mL of sodium). The final volume of the PN will be 2.5 liters to be infused at 100 ml/hr. What quantity, in milliliters, of each stock solution should be added to the PN to meet the requirements? Round to the nearest hundredth.
8.75 mL NaCl
22.5 mL Na acetate
45
30. A 2 liter PN solution is to contain 60 mEq of sodium and 30 mEq of acetate. The pharmacy has in stock sodium chloride (4 mEq/mL) and sodium acetate (2 mEq/mL). What quantity, in milliliters, of each solution should be added to the PN? Round to the nearest tenth.
7.5 mL NaCl
15 mL Na acetate
46
31. The pharmacist has calculated that a patient requires 30 mmol of phosphate and 80 mEq of potassium. The pharmacy has stock solutions of potassium phosphate (3 mmol of phosphate with 4.4 mEg of potassium/mL) and potassium chloride (2 mEg K/mL). How many milliliters each of potassium phosphate and potassium chloride will be required to meet the patient's needs?
10 mL Kphos
18 mL KCl
47
Corrected Calcium formula
48
32. Calculate the corrected calcium value for a patient with the following reported lab values:
9.6 mg/dL
49
33. A patient is to receive 8 mEq of calcium. The pharmacy has calcium gluconate 10% in stock which provides 0.465 mEg/mL. How many milliliters of calcium gluconate should be added to the PN? Round to the nearest whole number.
17 mL
50
34. A patient is receiving 30 mmol of phosphate and 8 mEq of calcium. The volume of the PN is 2,000 mL. There are 2 mEg PO4/mmol. Confirm that the sum of the calcium and phosphorus does not exceed 45 mEq/L.
34 mEq/L
51
35. What percent of calories will WT receive from the protein component? Round to the nearest whole number.
22%
52
36. How many calories will WT receive from the fat component of one (8 fl oz) shake?
Round to the nearest whole number.
160 kcal
53
37. What percent of calories are derived from the fat component? Round to the nearest whole number.
45%
54
38. How many calories will JB receive from the carbohydrate component if he receives
4 fl oz? Round to the nearest whole number.
75 kcal
55
39. What percent of calories will JB receive from the carbohydrate component? Round to the nearest whole number.
52%
56
40. The nurse was administering one carton (8 fl oz) of Osmolite to JB when she accidentally spilled 2 fl oz on the floor.
The remaining amount in the carton was accurately delivered to the patient. How many calories did he actually receive? Do not round the answer.
213.75 kcal
57
41. How many calories will the PN provide from protein each day? Round to the nearest whole number.
42. How many calories will the PN provide from carbohydrates each day? Round to the nearest whole number.
41. 306 kcal/day
42. 612 kcal
58
43. How many liters of this PN should be ordered to provide 1,420 kcals per day? Round to the nearest whole number.
2L
59
44. How many calories will this PN provide per day? Round to the nearest whole number.
1320 kcal per day
60
45. TE is a 35-year-old female who is receiving PN therapy with 325 grams of dextrose, 85 grams of amino acids and
300 mL of 10% lipids. What percentage of total calories is provided by the protein content? Round to the nearest whole number.
19%
