_01296_pediatric_nutrition

_01296_pediatric_nutrition - SCANNED TO PHARMACY STAT...

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Unformatted text preview: SCANNED TO PHARMACY STAT MEDICATION Date ___________________ Time ___________________ Nursing will hang a 24-hour bag daily at 2100. New orders or changes received after 12:30 pm will take effect the following day. PEDIATRIC PARENTERAL NUTRITION (>7.5 Kg) 1. Specify Route of Administration: Central OR Peripheral Note: Maximum dextrose concentration in Central PN = 35% Maximum dextrose concentration in Peripheral PN = 12.5% 2. Today's Weight ___________ Kg 3. Final Dextrose Concentration = ________% Note: Usually initiated with D10 and advanced by 2.5-5%/day, as tolerated. 4. Amino Acid = _________ gm/kg/day Note: Usually initiated at 1gm/kg/day and increased by 0.5-1gm/kg/day until goal achieved. Max = 3.5gm/kg/day. 5. PN Infusion Rate = ________ mL/hour over ________ hours = ________mL Total Note: Pharmacy will prepare a 24-hour supply, plus 50mL overfill, based on infusion rate ordered. 6. Fat Emulsion 20% ______ mL/hour over _____ hours = ________mL Total Note: 20% lipid supplies 2 kcal/mL. Up to 50% of daily calories may be administered as lipid. Initiate at 2.5-5 mL/kg/day Advance by 2.5 mL/kg/day, as tolerated, up to a maximum of 15 mL/kg/day (3gm/kg/day). Suggest infusing lipids over 20 hours. 7. Additives Select standard additives based on patient weight, or select and order tailored additives. Tailored 7.5 - 25 kg Over 25 kg Na (mEq/kg/day) K (mEq/kg/day) Ca (mEq/kg/day) Magnesium (mEq/kg/day) PO4 (mM/kg/day) 3 2 0.75 0.3 0.75 3 2 0.5 0.3 0.5 Chloride:Acetate ratio 1:1 1:1 Pediatric Recommendations 2-4mEq/kg/day 2-4mEq/kg/day 0.5-2mEq/kg/day 0.25-0.5mEq/kg/day 0.5-2mM/kg/day 1.5mEq Acetate is provided with each gm Amino Acid See note below. 5 (Pediatric) 10 (MVI-12) 0.2 mL/kg/day up 1 mL/day to 5 mL/day (Adult MTE-5) See note below. 2 mcg/kg/day 0 max 30 mcg/day 0 200 mcg/day 200mcg/day only if on MVI-12 MVI (mL/day) Pediatric Trace Metals Selenium Vitamin K (mcg/day) 0.5units/mL, if needed Heparin (units/mL) 10mg/kg/day if on TPN over 10 days Carnitine (mg/kg/day) Other Other Note: 5mL of Pediatric MVI contains: Vitamin A - 2331units, Vitamin B1 - 1.2mg, Vitamin B6 - 1mg, Vitamin B12 1mcg, Vitamin C - 80mg, Vitamin D - 400units, Vitamin E - 15.54units, Vitamin K - 200mcg, Biotin - 20mcg, Dexpanthenol - 5mg, Folic Acid - 140mcg, Niacinamide - 17mg, Riboflavin - 1.4mg. 10mL of MVI Adult contains: Vitamin A - 3300units, Vitamin B1- 6mg, Vitamin B6 - 6mg, Vitamin B12 - 5mcg, Vitamin C - 200mg, Vitamin D - 200units, Vitamin E - 10units, Biotin - 60mcg, Dexpanthenol - 15mg, Folic Acid - 600mcg, Niacinamide - 40mg, Riboflavin - 3.6mg, B2 - 3.6mg, Vitamin K - 150mcg. 0.1mL of Pediatric Trace Elements contains: Cr - 0.1mcg, Cu - 10mcg, Mn - 2.5mcg, Zn - 100mcg. 1mL of Adult Trace Elements contains: Cr - 10mcg, Cu - 1mg, Mn - 0.5mg, Zn - 5mg. SE - 60mcg. __________________________________________M.D. Caloric Profile: Dextrose: (_______%)x(________mL infused)x(0.034kcal/mg) = ______ Kcal Dextrose 20% Lipid:(______mL infused)x(2kcal/mL) = ______ Kcal Lipid ______ Total NonProtein Calories Protein: (______gm infused)x(4kcal/gm) = ________ Kcal Protein Total Kcal/Kg: (_____Kcal Dextrose) + (_____ Kcal Lipid) + (_____ Kcal Protein) ÷Kg = ______ Total Kcal/Kg Authorization for therapeutic substitution is given unless checked here Patient Identification Sutter Medical Center, Sacramento A Sutter Health Affiliate Parenteral Nutrition TPN Orders Pediatric 01296 (10/22/09) ORDERS ...
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