Pdillon

Fall 2011

The patient is getting 125ml/h of

D5%RL or 1000ml per 8 hours. How
many calories is she getting in 24
hours?
If 1000 ml is 8 hours, then 3000 ml
in 24.
Conversion factor =
1 Gram D5%RL = 3.4 calories

1 Gram of IV Dextrose = 3.4 Kcal/Gram

How many Grams of Dextrose in D5W

solution?
D5W means Dextrose in 5% solution =
5/100 gives you the amount of Grams in 1ml.
In this case it would = 0.05 Grams (50mg).
Then 1000ml = 50 Grams of Dextrose
(1000 ml x.05 Grams = 50 Grams)

Therefore, in 8 hours, since she is getting 3X

the amount or 3000 ml, it would be 3 X the
number of grams =150 Grams of Dextrose

RESULT: 150 Grams X 3.4 Kcal = 510 Kcal

The 2Kg infant is ordered to be

placed on TPN .
20% Dextrose at 10.8/hr.(Dextrose:
20%dextrose requires a central
line). For infants and children,
drug dosages are determined
based on weight in mg/kg (PO)
and mg/kg/min(IV).

**First remember 20 % dextrose = 20 grams/100ml = 0.2

grams dextrose/ml

THREE STEPS
STEP 1:
You need how much (mg or gm) in the
solution you will be giving: 10.8
ml/hour x 0.2 grams/ml = 2.16
grams/hour

To get this in minutes rather than the

hours, convert from hours to minutes (1
hr = 60 min.):
2.16 gm/hour divided by 60 min/hour =
0.036 grams/min = 36 mg/min (Since you
need mg/min, multiply the grams by
1000 to convert to milligrams: 1 gram =
1000 mg).

Now Divide by the weight of the infant to

see how much this 2kg infant will
receive:
36 mg/min divided by 2 kg =
18 mg/kg/minute.
**[You always check NORMS in PEDS with the infant before delivering
any drugs or fluids. This amount is in line with the normal
maximum of 18 - 20 mg/kg/minute. ]

1) b. IF THE MD ORDERED THAT THE 2KG

PATIENT ABOVE RECEIVE PROTEIN IN THE
HYPERALIMENTATION SOLUTION TO DELIVER
259.2 ML/DAY OF A 2.3 % PROTEIN SOLUTION,
HOW MUCH PROTEIN PER KG/DAY WOULD THE
INFANT BE RECEIVING?

3 STEPS

STEP 1:
2.3 % = 2.3 grams/100 ml =
0.023 gram/ml

2. 259.2 ml/day x 0.023 grams/ml =

Step 3.

5.96 grams/day

5.96 grams/day divided by 2 kg = 2.98

=
3 grams/kg/day of protein

Remember:

First check the norms and here for

premature and term infants. The required daily amount of
protein needed to promote nitrogen retention is 2.5 - 3
grams/kg/day, so this addition to the hyperal order would
provide an appropriate amount required .

3 STEPS:
Step 1.
20 % = 20 grams/100 ml =
grams/ml

Step 2.
28.8 ml/day x 0.2 grams/ml =
5.76 grams/day of fat

0.2

5.76 grams/day divided by 2 kg =

2.88 grams/kg/day of fat
** For premature infants or infants SGA the
maximum recommended amount of fat/day
would be 3 grams/kg/day, so this
hyperalimentation order would
provide an appropriate amount.

2) WHAT IS THE NON-PROTEIN CALORIC CONTENT OF

THE TPN ORDER FOR THIS 2KG INFANT?
i.e., HOW MANY KCAL/KG/DAY WILL THIS INFANT RECEIVE
FROM NON-PROTEIN SUBSTRATES ?

IS THAT CALCULATED AMOUNT SUFFICIENT FOR GROWTH?

3 STEPS
STEP 1:
10.8 ml/hour x 24 hours =
259.2 ml/day of a 20% dextrose solution.
[Again remember 20% = 20 grams/100 ml=
0.2 grams/ml]

STEP 2.
2. 259.2 ml/day x 0.2
grams dextrose/ml = 51.84 grams/day
dextrose.

Step 3.
Dextrose has 3.4 Kcal/gram, so
3.4 cal/gram x 51.84 gram =
176.3 Kcal from
dextrose