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The physician wants to start a new patient on a parenteral solution that provide

ID: 54051 • Letter: T

Question

  The physician wants to start a new patient on a parenteral solution that provides 350 grams of dextrose, 105 grams of AA and 40 gram s of lipids. Total volume of parenteral solution is 1951 ml/day. You want to determine osmolarity of solution.

Show ALL calculations.

mOsm of Dx:

mOsm of AA:

mOsm for vit and min:

Total mOsm:  

What is the best placement for this parenteral solution, central or peripheral?:

I am completely lost so please help and please show ALL work so I can better understand this problem! I appreciate your help in advance!

Calculations for Lipids:

Kcal: 1800kcal X .20 (20% fat) = 360 kcal from fat

360 kcal divided by 2 (20% IVFE) = 180 ml of 20% IVFE/day

180 ml divided by 12 hours = 15 ml of 20% fat for 12 hours

Calculations for Protein:

1800 ml (total volume) – 180 ml (lipids volume) = 1620 ml

75 gm divided by 1620 ml   X 100 = 4.6, you can round up to 5% AA

75 grams X 4 kcal/g of protein =   300 kcal

Calculations for Dextrose:

1800 kcal (total) – 360 kcal (lipids kcal) – 300 kcal (protein kcal) = 1140 Kcal of Dextrose

1140 kcal divided by 3.4 (kcal/g of dextrose) = 335 gm of dextrose

335 g divided by 1620 ml X 100 = 20% Dextrose

Explanation / Answer

For dextrose osmolarity calculation, the weight per liter (g/L) should be multiplied by 5, so that 179.395x5= 869.975 mOsm/L. then it would be about 1700 mOsm/1951ml.

For protein osmolarity calculation, the weight per liter (g/L) should be multiplied by 10, so that 53.8x10= 538.185 mOsm/L. then it would be about 1050 mOsm/1951ml.

For lipid osmolarity calculation, the weight per liter (g/L) should be multiplied by 1.5, so that 20.5x1.5= 30.75 mOsm/L. then it would be about 60 mOsm/1951ml.

Total mOsm is = 2810

You did not provide the concentration of minerals and vitamins. For minerals, you should multiply the mEq/L by 2.

The best placement for the parental solution is "central".

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