Protein Base Rate and TPN Indications Quiz

TPN Calculations

• The base rate for protein used in TPN calculations is 1.5-2.5 grams/kg/day.

Indications for TPN

• Absolute indications for TPN include:
  • GI obstruction
  • GI fistula
  • Radiation enteritis
  • Severe malabsorption
  • Intractable vomiting
  • Paralytic ileus

Electrolytes in TPN

• Calcium and phosphate are two electrolytes that can precipitate in TPN, causing problems such as pulmonary calcifications.

TPN Filter Size

• A 1.2 micron filter is used with a 3:1 TPN to prevent blockage.

Access Points for Parenteral Nutrition

• Three types of access points for Parenteral Nutrition are:
  • Central Venous Catheter (CVC)
  • Peripherally Inserted Central Catheter (PICC)
  • Midline Catheter

Metabolic Adjusted Weight (MAW) Calculation

• MAW is calculated using the following formula: MAW = IBW + (0.4 × (ABW - IBW))

Isotonic Enteral Feedings

• An enteral feeding solution is considered isotonic when it has an osmolarity of 300-800 mOsm/L.

Diarrhea from Enteral Feedings

• In case of diarrhea from an enteral feeding, the action to be taken is to:
  • Hold the feeding for 1-2 hours
  • Monitor for signs of dehydration
  • Consider adding an anti-diarrheal medication

Total Daily Fluid Calculation

• The total daily fluid calculation for a patient weighing 70kg is 2,450 mL (35 mL/kg/day).

Metabolic Adjusted Weight (MAW) and Filter Size

• The correct method for calculating MAW is: MAW = IBW + (0.4 × (ABW - IBW))
• A 1.2 micron filter is required to prevent blockage in a 3:1 TPN.