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Pass Naplex Now Book II > TPN > Flashcards

Flashcards in TPN Deck (13):
1

Dextrose

- Provides
- Max dose:



- Provides: 3.4 cal/gram
- Max: 500g/day in adults

2

Prolonged TPN contains

- Glutamine:
- Choline:



- Glutamine: protects gut epithelia lining
- Choline: protects liver from hepatic fat deposits

3

Minimum daily requires for protein

1.0 - 1.5g/kg/day

4

Alpha linoleic

Omega-3

5

Lineloic acid

Omega-6

6

Fat provides

- 1g of PO fat:
- 1g of IV fat emulsion



- 1g of PO fat: 9 cal
- 1g of IV fat emulsion: 10 cal

7

Fat emulsion calories

10%:
20%:
30%:



10% = 1.1 cal/mL
20% = 2.0 cal/mL
30% = 3 cal/mL

8

TPN electrolytes

- Never add HCO3
- Never add extra Ca

- Add ? first and last



- Never add HCO3: It ppt Ca++
- Never add extra Ca: It ppt PO4

=> First add PHOSphate then Last add Calcium

9

Trace element include

- Copper, Chromium, Cobalt
- Iron, Iodine, Fluride
- Manganese, Molybdenum
- Zinc, Selenium

=> Mixing iron w/ lipids cracks the emulsion => give separately or in TPN w/o lipids

10

Vit

- MVI -12
- MVI -13:



- MVI -12: Has all it except Vit K
- MVI -13 and Ped MVI have Vit K

11

Filters from TPN

- Dextrose and protein TPN: 0.22 micron filter
- Lipid emulsion: 1.2 micron filter

12

Monitors

- LFT
- Electrolytes
- Renal function
- Pre-albumin
- PT/PTT
- Nitrogen Balance

13

Nitrogen Balance (NB)

- Nitrogen intake
- Nitrogen loss
- Positive NB
- Negative NB



- Nitro intake: Daily protein intake/6.25
- Nitro loss: Daily protein in 24H urine + 4
- Positive: is our goal; anabolic state
- Negative: muscle wasting and weight loss