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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