This document provides instructions for calculating nutrients in a total parenteral nutrition (TPN) solution. It gives an example of calculating nutrients for a patient receiving a TPN solution of D15% dextrose and A5% amino acids at 75cc/hr plus 10% intralipid at 20cc/hr. The steps shown include calculating volume infused, grams of dextrose and amino acids, glucose utilization rate, calories provided, and percentage of calories from fat. Instructions are also given for recommending a TPN order based on a patient's nutrient needs.
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528 TPN Calculations
This document provides instructions for calculating nutrients in a total parenteral nutrition (TPN) solution. It gives an example of calculating nutrients for a patient receiving a TPN solution of D15% dextrose and A5% amino acids at 75cc/hr plus 10% intralipid at 20cc/hr. The steps shown include calculating volume infused, grams of dextrose and amino acids, glucose utilization rate, calories provided, and percentage of calories from fat. Instructions are also given for recommending a TPN order based on a patient's nutrient needs.
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TPN Calculations for a 2/1
When you have to calculate the nutrients in a given solution:
REMEMBER:
gm %
vol
Example: D15%A5% @ 75cc/hr + 10% IL @20cc/hr
Patient wt = 65 kg 1. Calculate the dextrose/AA volume infused in 24 hrs. 75cc/hr x 24 hrs = 1800cc 2. Calculate the grams of dextrose by multiplying the total volume by the concentration (%) of dextrose. 1800cc x 15% = 270 gms 3. Calculate the GUR (mg/kg/min) by multiplying the gm of dextrose by 1000, then divide by the patients weight in kg, then divide by 24 (hrs), then divide by 60 (min). 270 x 1000 = 270,000 65 = 4154 24 = 173 60 = 2.9 mg/kg/min 4. Calculate the grams of AA (protein) by multiplying the total volume by the concentration (%) of AA. 1800cc x 0.05 = 90 gms 5. Calculate total calories provided by TPN solution by multiplying the grams of dextrose and AA by their respective cal/gm. (dextrose = 3.4 cal/gm, AA = 4.0 cal/gm) Then add calories from fat by multiplying the ml infused in 24 hrs by 1.1 cal/ml of 10% IL or 2.0 cal/ml of 20% IL Dextrose: 270 gm x 3.4 = 918 calories AA: 90 gm x 4.0 = 360 calories IL: 480 ml (20ml x 24hrs) x 1.1 cal/ml (10% IL) = 528 calories 918 + 360 + 528 = 1806 total calories 6. Calculate % of calories from fat by multiplying the ml of IL by 10% or 20% to get the gm of fat, then multiply the number of gm by 9 cal/gm to get fat calories. Then divide fat calories by the total TPN calories and then multiply by 100 to get %. 480 ml IL x 10% = 48 gm fat x 9 cal/gm = 432 fat calories 432 fat calories 1806 total calories = 0.239 x 100 = 24% calories from fat
When you have to recommend a TPN order based on a patients nutrient needs: Example: Use Parenteral Case Study and fill in the steps.