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Calculations, Conversions, SI units

Table A Weight conversions:


1
1
1
1
1

Metric
kilogram (kg) = 1,000 grams (g)
gram = 1,000 milligrams (mg)
milligram = 1,000 micrograms (g)
microgram = 1,000 nanograms (ng)
nanogram = 1,000 picograms (pg)

English
1 ounce (oz) = 28 gram (g)
16 ounces = 1 pound (lb)
1 pound = 454 grams (g)
1 kilogram = 2.2 pounds
1 teaspoon (tsp) = ~ 5 grams
3 teaspoons = ~ 1 Tablespoon (Tbsp)

Table B Volume Conversions:


1 Liter (L) = 1,000 milliliters (mL)
1 cup (c) = 8 fluid ounces
1 liter = 1.06 quarts (qt)
1 cup = ~ 240 mL
4 cups = 1 qt
1 quart = 0.95 L
1 milliliter = 1 cubic centimeter (cc)** 1 teaspoon (tsp) = ~ 5 mL
1 Tablespoon (Tbsp) = ~ 15 mL
30 mL = 1 fluid ounce
2 Tablespoons = ~ 1 ounce
32 ounces = 1 qt
** Do not use this abbreviation on medical documentation
Table C - Length Conversions
1 inch = 2.54 centimeters (cm)
1 foot (ft) = 30.48 cm
1 meter (m) = 100 cm
1 meter = 39.37 inches
1 meter = 3.28 feet

Table D Temperature Conversion


To convert Celsius to Fahrenheit:
(9/5 * tc) + 32 = tf
To convert Fahrenheit to Celsius:
5/9(tf -32) = tc

Table E Milligrams and Milliequivalents


To convert milliequivalents (mEq) to milligrams (mg): mEq * Atomic wt/valence = mg

To convert mg to mEq: mg/atomic wt * valence = mEq

Element
Na+
K+
Cl-

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Table F Atomic Weights and Valences


Atomic Wt
Valence
Element
Atomic Wt
23
1
Mg++
24.3
39
1
Ca++
40
35.4
1

Valence
2
2

Table G Ideal Body Weight (IBW)


If the Hamwi method is preferred, it recommends the following procedures:
For males, it allows 106 pounds for the first 5 feet plus 6 pounds for
every additional inch over 5 feet.
For females, 100 pounds is allowed for the first 5 feet plus 5 pounds
for each additional inch.
Up to 10% can be added for a large frame and up to 10% can be
subtracted for a small frame. Example: 120 10%.
To estimate IBW for people below 5:
cm2/10000 x 18.6 24.9 = range of IBW
For males, it allows 106 pounds for the first 5 feet minus 3-6
pounds for every inch below 5 feet.
For females, it allows 100 pounds for the first 5 feet minus 2.5-5
pounds for every inch below 5 feet.
Table H Percentages
% IBW and % UBW
% of Weight Loss
% IBW = Actual Weight x 100
UBW Actual Body Weight = Loss of
IBW
Weight
Loss of Weight * 100 = % of Weight Loss
% UBW = Actual Weight x 100
UBW
Usual Body Weight
Table I Adjusted Body Weight (ABW)
ABW = [(Actual body weight IBW) * 0.25] + IBW
ABW2 = [(IBW Actual weight) * 0.25] + Actual Body Weight
Example: 150 lbs, Female, 54
[(150-120) * .25] + 120 = 127.51
[(120-150) * .25] + 150 = 142.52
1

Metric
BMI = Weight in kg
Height in m2

Table J Body Mass Index (BMI)


English
BMI = Weight in lbs
* 703-705
2
Height in inches

Table K BMI for amputees


Estimated Weight: Wtestimate = Wtcurrent x (1-Pmissing limb)
Foot 1.5%
Hand 0.7%
Total leg 16%
Calf 4.4%
Forearm 1.6%
Total arm 5%
Thigh 10.1%
Upper arm 2.7%
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Use this estimated weight to determine BMI


Table K Body Mass Index Categories
Underweight
<18.5
Normal weight
18.5 -24.9
Overweight
25 -29.9
Obesity
30 or 39.9
Morbid Obesity
>40

Table L Midarm Muscle Circumference (MAMC)


MAMC (cm) = midarm circumference (cm) [3.14 * triceps skinfolds (mm)]
Table M Total Lymphocyte Count (TLC)
TLC (mm3) = WBC mm3 x % Lymphocytes
Table N Rule of Nines
The Rule of Nines is used to obtain an estimate of the body surface area
burned. With this method, each of the following body areas is assumed to
cover the indicated percent of the body surface area.
Each arm 9%
The posterior truck 18%
Each leg 18% -- Adult
The head 9%
Each leg 14% -- child
The perineum 1%
Anterior trunk 18%
Table O1 Waist to Hip ratio:
Waist to Hip ratio = Waist measurement
Hip measurement
Health problems increase if female .8 and males .9
Table O2 Waist Circumference
Men < 40

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Women < 35

Table P Nitrogen Balance


The determination of nitrogen balance requires knowing the 24 hour nitrogen
intake and output. To estimate nitrogen from dietary protein, use either of
these formulas:
Nitrogen intake = Protein intake (g)
or
Protein intake (g) *16%
6.25
Nitrogen output per day equals the measured urea urinary nitrogen (UUN) plus
a factor of 4 g to account for nitrogen losses thru the feces, hair, skin, and
nails as well as non-urea nitrogen losses in the urine.
Nitrogen output = UUN + 4 gm
Nitrogen Balance = Protein intake (g) - (UUN + 4g)
6.25
Table Q1 BEE (Harris-Benedict Equation) use AF and IF
Women -- Adults
BEE = 655 + [9.6 * kg] + [1.85 * cm] [4.7 * age]
Men -- Adults
BEE = 66 + [13.7 * kg] + [5 * cm] [6.8 * age]
Table Q2 Mifflin-St. Jeor Equation use AF and IF
Male Resting metabolic rate = (9.99 x Actual kg) + (6.25 x cm) (4.92 x age) + 5
Female Resting metabolic rate = (9.99 x Actual kg) + (6.25 x cm) (4.92 x age) -161
Table R Pediatric Needs
Kcalories
100 kcal/kg/day for first 2-10 kg
50 kcal/kg/day for the next 10-20 kg
20 kcal/kg/day for the next 20 kg
*** Increase calories 20-40% for catch up growth
Age
Protein
Age
Fluid needs
0-1
2.5 g/kg
0-1
125-160 mL/kg
1-3
1.5-2.0 g/kg
1-3
115-135 mL/kg
4-6
1.5 g/kg
4-6
90-110 mL/kg
7-10
1.0-1.5 g/kg
7-10
70-90 mL/kg
11-14
1 g/kg
11-14
50-85 mL/kg

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Table S1 Vent-dependent patient (Ireton-Jones Energy Equation)


V=vent dependent; sp = spontaneously breathing (critically ill not vented)
A = Age; W = wt in kg; S = gender (male = 1; female = 0); T = dx of trauma
(present = 1, absent =0); B = dx burn (present = 1, absent = 0); O = obesity
BMI>27 or 30% >IBW (present = 1, absent = 0)
V=1925-10(A) + 5(W) + 281(S) + 292(T) + 851(B)
Sp = 629 11(A) + 25(W) 609(O)
Table S2 -- Acid Base Balance
CO2 + H20 H+ = HCO3
Lung-respiratory
Kidney - Metabolic
If lungs decrease vent: CO2 ____ H+ ___
pH _____
Condition: _______________________________________
Kidneys compensate by: ____________________________
Example: _______________________________________
If cells produce more or excrete less acid: CO2 ____ H+ ___
pH _____
Condition: _______________________________________
Lungs compensate by: _____________________________
Example: ________________________________________
If lungs increases vent: CO2 ____ H+ ___
pH _____
Condition: ______________________________________
Kidneys compensate by: ___________________________
Example: ______________________________________
If cells lose acid or accumulate base: CO2 ____ H+ ___
pH _____
Condition:_______________________________________
Lungs compensate by: _____________________________
Example: ______________________________________
Table T Injury Factors JPEN 1979
This is used as a guide not a definitive IF
Acute Pancreatitis
AIDS
Alcoholic Hepatitis
ARDS 2 Sepsis and Multiple Stresses
ARF
Asthma/Acute Bronchitis
Burn < 20% BSA
Burn > 40 BSA

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1.2-1.4
1.6
1.2-1.3
1.2-1.4
1.5-2.0
1.2
1.0-1.5
1.85-1.95

Burn 20-40% BSA


Burn 100% BSA
Cancer
Chronic Pancreatitis
Cirrhosis
Closed Head Injury
CRF
CHF/COPD
Elderly
Encephalopathy
Fever (each degree above 98.6 F)
Head Trauma Tx w/ steroids
HD
Healthy Adult/no Stress
Hepatic Failure
Hepatitis, Active
HIV, Stable
HIV, symptomatic
Infection
Mild
Moderate
Severe
IBD
Lactation
Liver Transplant
Major surgery
Multiple Trauma on vent
PD
Peritonitis
Pregnancy (4-9 months)
Post op, No complications
Pulmonary Disease
Refeeding syndrome
Renal Transplant
Sepsis (1st week)
Sepsis (2nd week)
Trauma, Blunt
Trauma, Skeletal
Wound Healing/Decub
Stage 1
Stage 2
Stage 3
Stage 4

1.5-1.85
1.9
1.1-1.45
1.7-1.9
1.2-1.3
1.3-1.5
1.1-1.4
1.25
1.2-1.3
1.2-1.3
1.07
1.4-1.7
1.5-2.0
1.0
1.2-1.45
1.0-1.2
1.15-1.25
1.15-1.4
1.0-1.2
1.2-1.4
1.4-1.8
1.3-1.5
1.25
1.2-1.4
1.2-1.5
1.5-1.7
1.5-2.0
1.051.25
1.15
1.0-1.1
1.3
.65-.85
1.2-1.4
1.2-1.4
1.3-1.55
1.15-1.35
1.2-1.35
1.2
1.45
1.68
1.92

Table T1 -- Additional Factors used to calculate total energy needs


Total Energy Needs = BEE or (REE) * Activity Factor * Injury Factor
Activity Factor
Injury Factor
Fever Factor
Confined to bed 1.2
Minor surgery 1.1
Each F above 98.6
1.07
Out of bed 1.3
Major surgery 1.2
Minor infection
Seated work, little
Moderate infection
or no activity 1.61.4
1.7
Peritonitis 1.2-1.5
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Standing work or
30-60 min activity
4-5 x weekly 1.81.9
Strenuous work 2.02.4

Soft tissue trauma


1.14 1.37

Skeletal trauma 1.35


Starvation 0.7
Head injury w/
steroids 1.6
Major sepsis 1.4-1.8
40% body burn 1.5
100% body burn 1.95

Table U Protein Factors


Factors
Protein based on body weight
Pregnancy (normal)
.8 g/kg + 15 to 25g
Hi Risk Pregnancy
2.0 g/kg
Lactating
.8g/kg
Healthy
.8 g/kg
Hemodialysis
1.0-1.2 g/kg
Peritoneal dialysis
w/o infection
1.2-1.5g/kg
w/ infection
1.5-2.0 g/kg
CRF w/o dialysis
.6-.8 g/kg
Hepatic coma
.6-.8 g/kg initially
Table U1 Corrected Calcium
[(4-Albumin) * .8] + Ca++ = Corrected Ca++

Table W Total Iron Binding Capacity (TIBC) Calculation


Transferrin * 1.25 = TIBC
Table X Transferrin Calculations
Transferrin = 0.8 * TIBC - 43
Transferrin = 0.9 * TIBC - 4.5
Transferrin = 0.87 * TIBC + 10
Transferrin Sat % = Serum Fe * 100
TIBC
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Table Y1 Renal Calculations


Creatinine Height Index
CHI = Actual 24 hr creatinine excretion * 100
(CHI)
Expected 24 hr creatinine
Creatinine Clearance
Men:
Est. Cr Cl = [[140 - age]*kg]
(stable)
[72*serum Cr]
Women:
Glomerular Filtration Rate
(GFR)

Est. Cr Cl = [[140 - age]*kg] * 0.85


[72*serum Cr]
2
GFR (mL/min/1.73m )=(186 * Cr-1.154) * (Age-0.203) *
(0.72female) * (1.210African-American)

Table Y2 Creatinine
> 25
20-25
15-20
10-15

Clearance Values
No restriction
70-90 gm/day
50-70 gm/day
20-40 gm/day

Table Y3 - Using GFR Values to stage level of Renal Dysfunction


Stage
GFR Level
1
90
2
60-89
3
30-59
4
15-29
5
<15
Table Z Osmolality (mOsmol/kg)
Osmolarity (mOsmol/L)
blood
mOsmol/L
= 1.86 * (Na+) + (Glu)/18 + (BUN)/2.8
mOsmol/Lparenteral = (g/L dextrose * 5) + (g/L protein * 10) +
(g/L fat * .71) + [(mEq/L Na+*2) + (mEq/L K+ * 2) + (mEq/L
Ca++ * 1.4) + (mEq/L Mg++ * 2)]

Adult mOsmol/kgenteral = (g pro * 5.8) + mEq(Na+ + Cl- + K+)


Child mOsmol/kgenteral = (g pro * 4.0) + mEq(Na+ + Cl- + K+)
Table AA Propofol calculations
Propofol is a medication that provides sedation for patients typically on a vent.
It is mixed with a 10% lipid and administered IV. Therefore, it does contain
calories.
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Kcal from propofol = (Rate mcg/kg/hr of propofol * 24 hr) * 1.1kcal/mL


Table BB Determining Glucose Utilization Rate (GUR):
g dextrose * 1000 = mg dextrose/kg/min
(kg)(1440min)
Adults 5 mg/kg/min;

Neonates 16 mg/kg/min

Table CC Fluid Calculations for children, adults and disease states


First 10 kg = 100 mL/kg
11-20 kg = 1000 mL + 50 mL/kg for each kg above 10 kg
> 20 kg = 1500 + 20 mL/kg for each kg above 20 kg
25-55 yrs 35 mL/kg
Edema/CHF 25 mL/kg
56-65 yrs 30 mL/kg
ARF FO = FI
>65 yrs 25 mL/kg
CRF FO + 1000 mL
Table DD1 Quick est. of caloric needs (Use current wt and adj. for frame)
Obese, Very inactive, chronic dieters
10-12 kcal/lb
20 kcal/kg
Persons > 55 years, active women, sedentary men 13 kcal/lb
25 kcal/kg
Active men, very active women
15 kcal/lb
30 kcal/kg
Thin, very active men
20 kcal/lb
40 kcal/kg
Table DD2 Determination of Frame Size
Height is obtained w/o shoes; wrist circumference is measured just distal to
the styloid process using a tape measure.
r = Height (cm)/ Wrist circumference (cm)
Male
Female
r > 10.4 = small
r > 11.0 = small
r = 9.6 to 10.399 = medium
r = 10.1 to 10.999 = medium
r < 9.6 = large
r < 10.1 = large

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Exchange Group
Starch
Fruit
Low K
Med K
High K
Milk

Table EE - Diabetic/Renal
CHO
PRO
FAT
Na+
15
3
0-1
80
15
0
0
0
15
0
0
0
15
0
0
0
15
0
0
0

Exchange
K+
35
150
70
150
270

PO4
35
15
15
15
15

CAL
80
60
60
60
60

Whole Milk
2% fat Milk
1% fat Milk
Skim Milk
Vegetable
Low K
Med K
High K
Fat
Meat

12
12
12
12
5
5
5
5
0

8
8
8
8
2
2
2
2
0

10
5
1-3
0
0
0
0
0
5

160
160
160
160
15
15
15
15
55

360
360
360
360
150
70
150
270
10

220
220
220
220
20
20
20
20
5

150
120
100
80
25
25
25
25
45

High Fat
Medium Fat
Low Fat

0
0
0
0

7
7
7
7

8
5
3
0-1

25
25
25
25

100
100
100
100

65
65
65
65

100
75
55
35

Very Low Fat

Table FF Classification of anemia


Iron Deficiency
B12 or Folate
(microcytic)
(macrocytic)
RBC
Hgb
Hct
MCV
MCH
MCHC

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May be normal
Low
Low
Low
Low
Low

Decreased
Low
Low
High
High
Slightly decr or
nor

Anemia of
Chronic Disease
(normocytic)
Decreased
Low
Low
Normal
Normal
Normal

TIBC
Nutritiona
l Factor

Condition
Spina Bifida

Spina Bifida
Down
Syndrome
Prader Willie

Low
Folate, B12

Low
Protein

Table GG Special Kcal Conditions


Kcal/centimeter
Age
Protein requirements for
(cm) ht
special conditions (g/kg)
Weight
0-.5 mths/.6-1 mths
2.2/1.8
Maintenance 911
Weight Loss 7
4-6 years/7-10 years
1.2/1.1
Males 16.1
Males 11 14 years
1.0
Female 14.3
Males 15 - 18
.9
14
Females 11 14 years
1.0
Females 15-18 years
.9
13.9

Mild-Moderate
motor
dysfunction
Severe Motor
11.1
Dysfunction -nonambulatory
Athetoid
16.1
Cerebral Palsy
Spastic
11.1
Cerebral Palsy

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High
Iron

Used to Evaluate
Diabetes

Kidney

Liver

CHD

Pancreas

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Table HH Blood tests


Blood Serum Component
FBS, Hgb A1C
Sodium
Chloride
Potassium
BUN
Creatinine
Uric Acid
Calcium
Phosphorus
Alkaline Phosphatase
Total Protein
Albumin 21 days
Globulin
CRP
Pre-Albumin 1.9 days
Retinol Binding Protein 12 hr
Transferrin 8-10 days
SGOT
SGPT
LDH
GGTP
Total bilirubin
Cholesterol
Triglycerides
HDL
LDL
Troponin
T3
T4
TSH
Amylase
Lipase

Used to Evaluate

Metabolic

Bone & Joint

Infection/Nutrition
Status

Cardiac

Thyroid

Table II Difficult anthropometric assessments for the elderly


Area
Gender
Measurement
Formula
Stature Female Knee Height (cm)
[1.83 * kh] - [0.24 * age] + 84.88
Weight Female Calf Circumference C
Est. wt = [1.27 * C] + [0.87 * kh] +
(cm)
[0.98 * MAC] + [ 0.4 * Subsc SF]
Knee Height kh (cm)
62.35
Mid arm circumference
MAC (cm)
Subscapular skinfold
thickness Subsc SF (mm)
Stature Male
Knee Height (cm)
[2.02 * kh] - [0.04 * age] + 64.19
Weight Male
Calf Circumference C
Est. wt = [0.98 * C] + [1.16 * kh] +
(cm)
[1.73 * MAC] + [ 0.37 * Subsc SF]
Knee Height kh (cm)
81.69
Mid arm circumference
MAC (cm)
Subscapular skinfold
thickness Subsc SF (mm)

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