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6.Robert is a 81 year old man admitted to the ICU with necrotizing pancreatitis. He has an NGT in place draining ~750 ml x 24 hours. He has a PMH of type 2 DM. Robert has been receiving PN x 7 days now. Previous days TPN is as follows:
150 g Dextrose
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Write My Essay For Me160 g Amino acids
250 ml 20% lipid emulsion
2.0 liters fluid – TPN infusion at 83 ml/hr continuously
150 mEq NaCl
25 mEq Na Acetate
20 mEq KPhos
16 mEq MgSo4
10 mEq CaGluconate
20 mg Famotidine
12 Units Regular insulin
10 ml Multivitamin
1 ml Standard Trace Elements
Today’s Labs: WBC 10.3, Hgb 13.8, Hct 43.4, Plt 324 Na 148, K 4.0, HCO 18, BUN 17, Cre 1.1, Glu 272, Alb 2.5 Mg 2.6, Phos 3.3, Ca 11.1, AST/ALT 142/235, TG 798
Fingersticks over the past 24 hours are as follows: 183-161-165-154
Write new PN orders for tomorrow
7. Jenny is a 67 year old female admitted to the ICU s/p repair of a perforated gastric ulcer. She develops a RUQ abscess requiring a drain that is putting out 1350 ml per day. She was NPO x 10 days prior to the initiation of PN.
Jenny is 62 inches tall and 145# in weight
Previous days TPN is as follows:
100 g Dextrose
100 g Amino acids
1.5 liters fluid – TPN infusion at 63 ml/hr continuously 150 mEq NaCl
50 mEq Na Acetate
60 mEq KCL 16 mEq MgSo4
10 mEq CaGluconate
20 mg Famotidine
10 ml Multivitamin
1 ml Standard Trace Elements
5 mg Zinc
Labs: WBC 4.3, Hgb 12.9, Hct 37.8%, Plts 385 Na 159, K 2.8, HCO3 19, BUN 16, Cre 1.0, Glu 132, Alb 1.5 Mg 1.8, Phos 2.1, Ca 6.4, AST/ALT normal
Write new PN orders for tomorrow
SUBJECT-NUTRITION
