1. A patient with Chronic Kidney Disease (Stage IV), who makes very little urine, presents to the hospital with severe nutritional deficiencies. You are starting her on TPN for nutritional support. Her Non-protein calorie requirement is 1600 kcals. Which lipid product would you choose and why?
2. What is the formula or recipe (%) of the following PN bag containing the following ingredients: Dextrose 425g, Protein 84g, total volume 2000mL?
3. A 38 yo female is initiated on a PPN for nutritional support. On the second day of administration, she develops swelling around the peripheral IV site accompanied by erythema and pain. The current bag contains: Dextrose 387g, Protein 90g, total volume 1600mL
4. AJ 37 yo female is admitted to the burn ICU for burn injuries sustained during a house fire. She has 30% total body burns and is in critical condition. Prior to the house fire, she was in her usual state of health.NKDA Current Meds: Zosyn 4.5g q8hPMH: HTN Vancomycin 1g q12hSocH: (+) tobacco Furosemide 40mg IV q12h Famotidine 40mg IV daily Wt: 64 kg Ht: 170 cm Morphine PCA
i. Protein ii. Dextrose iii. Lipids (20% lipids ______ mL)5. AJ develops chronic renal failure after 6 months of hospitalizations and rehabs (CrCl= 22 ml/m). She is not undergoing dialysis or CRRT. How does this change your TPN formula (say in words, do not re calculate)?