PN Pt 2 Flashcards
(29 cards)
What are the calories in the following: Carbs Protein Fat (Intralipid 20% or 30%) Fat (Liposyn 10%) Alcohol
Carbs 3.4 kcal/g Protein 4 kcal/g Fat (Intralipid 20% or 30%) 10 kcal/g Fat (Liposyn 10%) 1.1 per mL kcal/g Alcohol 7 kcal/g
What is the IBW for males
50 + (2.3 * inches over 5’)
multiply by 1.25 to see if you need to use ABW
What is the IBW for females
45.5 + (2.3 * inches over 5’)
multiply by 1.25 to see if you need to use ABW
What is Adjusted BW
When do you use it
IBW + 0.25 * (ABW - IBW)
Use it when actual weight is over 25% of IBW
What is the weight based estimation of energy calories
20-35 kcal/mL
What are the usual protein requirements?
0.8-1 g/kg/d
What are the protein requirements in renal failure
0.6-0.8 g/kg/d
What are the protein requirements in HD
1.1-1.4 g/kg/d
What are the protein requirements in liver failure
0.5-1 g/kg/d
What are the protein requirements in the critically ill
1.2-1.5 g/kg/d
What are the protein requirements in burn victims
1.5-2 g/kg/d
What are the protein requirements for someone undergoing continuous renal replacement therapy (CRRT)?
1.7-2 g/kg/d
What are fluid requirements for newborn to young adult
100 ml/kg for 1st 10 kg
50 ml/kg for next 10 kg
20 ml/kg for every kg over 20 kg
What are the fluid requirements for 25-55 yrs
35 ml/kg
What are the fluid requirements for 56-65 yrs
30 ml/kg
What are the fluid requirements for over 65 yrs
25 ml/kg
How do you convert lb to kg
divide by 2.2
2.2 lb is 1 kg
What are the calculation steps
- Calculate calorie needs (BEE or 20-25 kcal/kg)
- Determine protein needs
- Calculate non-protein calories
- Calculate dextrose
- Calculate lipids
- Determine fluid volume
How do you calculate caloric needs of a pt?
BEE or assume 20-25 kcal/kg
How do you determine protein needs?
Determine protein requirement based on the table (or given) then multiply by the weight
ie a 70kg critically ill pt needs 1.2 g/kg
1.2 times 70 is 84 g
How do you calculate protein calories needed?
Multiply protein in g needed by how many kcals are in a gram of protein
(it’s 4 kcal/g)
How do you calculate non-protein calories?
Subtract protein calories from total calories
How do you intervene with a pt who has hypertriglyceridemia? What levels would they have?
Adult over 400, infants/pediatrics 150-200
Intervene by reducing rate or dose, withholding IVFE, and using low dose heparin (in neonates)
How should PN be administered in pts with hyperglycemia?
Initiate 100-200g of dextrose with 0.05 to 0.1 units of insulin per gram of dextrose for mild hyperglycemia (130-150)
for 151-200:
Increase insulin dose to 0.15-0.2 units/g of dextrose
Monitor BG every 4-6 hours
