A nurse is caring for a client who has a prescription forparenteral nutrition. I beg your pardon of the actions have to the nursetake?
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TPN - SC best line 2200 ml complete volume x 24 hours st 2 rows ③ Amino acid: 458 / liter 15 22 ho a = 459x2.24 = 99 grauss & Ak carxgons = 309keals
Dextrose 1759 / ulex 210 = 125gx2.2 l = 385 9 x 3.4 kcals/g=1309keals ③ lipid 20% 285 mL over 24 hours. In ~ tuos - 285 mis x 2 = 570 kcalss stoloupe over will carry out 2275 Keal, 99g protein, ④ DIR - (3859 dex/ 70 kg / 1440 min in a work & 1000 project = 3.8 ing/kg/min. ② LR = (285 mis lipid +20%) / 70kg = 0.8 g/kg/day. T vori Woc) ( ( glucose security a) check daily electrolytes and adjust TPN/PN elec- trolyte additive accordingly, anotooor through cheek accu-cheek glucose together hoon (regulas insulin oso may be added to TPN/ PPN bag. Control as needed) to loco ix Non-odiabetics or NIDDHS begin with half of the vault day's sliding range insulin reg. In TPN/PPN bag and increase everyday in the very same manner untill target glucose is reached. & lüx IDOM: begin with oil units constant insulin gram si dextrose in TPN/PPN, then in- crease everyday by half st-the previous days Sliding range insulin requirement.
nye cy inspect triglyceride level in ~ 24 hours of starting TPN/ PPN iy If TG7250-400 mg/au, lipid infusion need to be signi- ficantly lessened uy consider including carne well , grama everyday to TPNL ng Carne fine i gram PPN to boost lipid metabolism. ~ 100g tat per week is necessary to protect against esse fatty mountain deficiency. Dy check LET's weekly- iy If LET's considerably elevated considerably elevated together a result - TPN, together then minimize lipids to Lig/Kdy day and also cycle TPN/PPN over 12 hours to remainder the liver. üx If Bilirubin > 5-10 mg/de as result of hepatic dystanc- tion, then discontinue trace aspects due to pote- utial for toxicity of manganese and also copper. Ex examine pre-albunan Weekly- readjust amino mountain content of TPN/PPN come reach typical pre albumin 18-35 ng/dL uy Adeguate amino acid provided when over there is rise in pre- albumin eta Ing/dl per day fy acid Base Balance ix adjust- TPN/PPN anion concentration to maintain ideal Acid basic balance uz rise / diminish chloride contents as needed. Ny due to the fact that bicarbonate is stormy in TPN/PPN Preparation, the Pre cansor - acetate is used change acetate contents as needed.
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