13. 100% of RDIS are met with 1321 mL/day. So Patient's RDIS are being met by Osmolite. = Example #2 1800 mL (goal volume) 136% of RDIS provided by Osmolite 1321 mL (volume needed to meet 100% of RDIs) • Estimated daily needs for 62 kg: 1750 to 1950 kcal (28 - 31 kcal/kg), 75 to 85 grams protein (1.2 - 1.3 gm/kg), 1850 to 2050 mL (30-33 mL/kg) •No IVF. No significant volume of fluid from medications. ⚫ Osmolite (standard formula) with 300 mOsm: x 100 7. Based on daily goal volume, calculate grams of carb. L x 143.9 gm carb =259 gm carb 1.8 L 1.06 kcal/mL 0 gm fiber/L 8. Based on daily goal volume, calculate grams of fat. x 34.7 gm fat = 62 gm fat/day 1.8 L L 44.3 gm protein/L 100% RDIS met with 1321 mL/day 143.9 gm CHO/L 34.7 gm fat/L 84.2% water 9. Based on daily goal volume, calculate grams of fiber. formula does not contain fiber. This 1. Determine the estimated daily goal volume. This is a guesstimate. 1850 kcal x 1 mL = 1745 mL 1.06 Kcal 2. Determine the estimated hourly rate. This is a guesstimate. 1745 mL = 72.7 mL/hr 24 hrs 3. Determine the final hourly rate. Round up to: 75 mL/hr 10. Based on daily goal volume, calculate mL of free fluid. 1800 mL x 84.2% = 1515 mL free fluid/day 11. Determine the volume of water flushes need to meet estimated needs. Take into account all other sources of fluid such as IV fluids and any significant fluid from IV medications. 1950 mL 1515 mL free fluid in formula mL water flushes = 435 4. Calculate the daily goal volume. 1800 mL/day = 1.8 L/day 75 mL/hr x 24 hrs/day 12. Determine administration of water flushes. 5. Based on daily goal volume, calculate the calories. Also note kcal/kg. 1800 mL x 1.06 kcal = 1908 kcal per day which provides 30 kcal/kg mL 6. Based on daily goal volume, calculate the grams of protein. Also note kcal/kg. 1.8 L x 44.3 gm protein 79 gm protein, which provides 1.2 gm/kg L 100 mL every 6 hours (4x/day) to provide 400 mL/day. Total fluid via EN: 1515 mL free fluid + 400 mL water flushes 1915 mL/day If there is any concern for dehydration, another appropriate recommendation could be: 120 mL every 6 hours (4 x/day) to provide 480 mL/day. Total fluid via EN: 1515 mL free fluid + 480 mL water flushes 1995 mL/day = 2000 mL/day Mr. Cal E. Fornia, 25YOM, is a totally righteous dude. He was surfing some gnarly waves and like totally wiped out. He is admitted to the hospital with a closed head injury. There is no history of chronic illness or weight loss. Height is 5 feet 9 inches • Current weight is 154 pounds (70 kg) • Estimated kcal needs: 2000 to 2200 kcal/day (30 kcal/kg) • Estimated protein needs: 88 to 98 gm protein/day (1.2 to 1.4 gm/kg) • Estimated fluid needs: 2000 to 2200 mL/day 930 mL/kg and 1 mL/kcal) Mr. Fornia is NPO and an NGT is placed. IVF are at 75 mL/hr. You receive a consult for EN recommendations. You decide to use Osmolite, a standard formula: •1.06 kcal/mL • 44.3 gm protein/L • 143.9 gm CHO/L • 34.7 gm fat/L • O gm fiber/L • 100% RDIS met with 1321 mL/day • 84.2% water a. What is your recommendation for hourly rate and goal volume of Osmolite? b. The daily goal volume provides how many: kcal, gm protein, gm carb, gm fat and mL free water? c. What is the percentage of RDIS met with the goal volume?

13. 100% of RDIS are met with 1321 mL/day. So Patient's RDIS are being met by Osmolite. = Example #2 1800 mL (goal volume) 136% of RDIS provided by Osmolite 1321 mL (volume needed to meet 100% of RDIs) • Estimated daily needs for 62 kg: 1750 to 1950 kcal (28 - 31 kcal/kg), 75 to 85 grams protein (1.2 - 1.3 gm/kg), 1850 to 2050 mL (30-33 mL/kg) •No IVF. No significant volume of fluid from medications. ⚫ Osmolite (standard formula) with 300 mOsm: x 100 7. Based on daily goal volume, calculate grams of carb. L x 143.9 gm carb =259 gm carb 1.8 L 1.06 kcal/mL 0 gm fiber/L 8. Based on daily goal volume, calculate grams of fat. x 34.7 gm fat = 62 gm fat/day 1.8 L L 44.3 gm protein/L 100% RDIS met with 1321 mL/day 143.9 gm CHO/L 34.7 gm fat/L 84.2% water 9. Based on daily goal volume, calculate grams of fiber. formula does not contain fiber. This 1. Determine the estimated daily goal volume. This is a guesstimate. 1850 kcal x 1 mL = 1745 mL 1.06 Kcal 2. Determine the estimated hourly rate. This is a guesstimate. 1745 mL = 72.7 mL/hr 24 hrs 3. Determine the final hourly rate. Round up to: 75 mL/hr 10. Based on daily goal volume, calculate mL of free fluid. 1800 mL x 84.2% = 1515 mL free fluid/day 11. Determine the volume of water flushes need to meet estimated needs. Take into account all other sources of fluid such as IV fluids and any significant fluid from IV medications. 1950 mL 1515 mL free fluid in formula mL water flushes = 435 4. Calculate the daily goal volume. 1800 mL/day = 1.8 L/day 75 mL/hr x 24 hrs/day 12. Determine administration of water flushes. 5. Based on daily goal volume, calculate the calories. Also note kcal/kg. 1800 mL x 1.06 kcal = 1908 kcal per day which provides 30 kcal/kg mL 6. Based on daily goal volume, calculate the grams of protein. Also note kcal/kg. 1.8 L x 44.3 gm protein 79 gm protein, which provides 1.2 gm/kg L 100 mL every 6 hours (4x/day) to provide 400 mL/day. Total fluid via EN: 1515 mL free fluid + 400 mL water flushes 1915 mL/day If there is any concern for dehydration, another appropriate recommendation could be: 120 mL every 6 hours (4 x/day) to provide 480 mL/day. Total fluid via EN: 1515 mL free fluid + 480 mL water flushes 1995 mL/day = 2000 mL/day Mr. Cal E. Fornia, 25YOM, is a totally righteous dude. He was surfing some gnarly waves and like totally wiped out. He is admitted to the hospital with a closed head injury. There is no history of chronic illness or weight loss. Height is 5 feet 9 inches • Current weight is 154 pounds (70 kg) • Estimated kcal needs: 2000 to 2200 kcal/day (30 kcal/kg) • Estimated protein needs: 88 to 98 gm protein/day (1.2 to 1.4 gm/kg) • Estimated fluid needs: 2000 to 2200 mL/day 930 mL/kg and 1 mL/kcal) Mr. Fornia is NPO and an NGT is placed. IVF are at 75 mL/hr. You receive a consult for EN recommendations. You decide to use Osmolite, a standard formula: •1.06 kcal/mL • 44.3 gm protein/L • 143.9 gm CHO/L • 34.7 gm fat/L • O gm fiber/L • 100% RDIS met with 1321 mL/day • 84.2% water a. What is your recommendation for hourly rate and goal volume of Osmolite? b. The daily goal volume provides how many: kcal, gm protein, gm carb, gm fat and mL free water? c. What is the percentage of RDIS met with the goal volume?

Curren'S Math For Meds: Dosages & Sol

11th Edition

ISBN:9781305143531

Author:CURREN

Publisher:CURREN

Chapter20: Iv Medication And Titration Calculations

Section: Chapter Questions

Problem 29SST

See similar textbooks