Beruflich Dokumente
Kultur Dokumente
ADULTO:
Peso 54kg
Talla 1.85m
Urea 13,85g/L
Diuresis de 1950cc
Post quirrgico de Ca de esfago, inicia con Nutricin parenteral se
solicita:
Urea en 24 horas
Con diuresis de 1950cc
Valores de Urea Urinaria de 13,85g/L Considerar lo siguiente.
K: 2,7mEq/ml
Ca2: 0.46mEq/ml;
P=20mEq/d; 1ml
PO4=0,6mmlrs y =1.mEq/mlK
Vit/Oligoelementos=ampx10cc/d c/u
VIG =2,5mg/kg/min/da
Lpidos =0,8g/kg/da
Volumen Final=2000ml.
Determinar:
1.- Los gramo de macronutrientes y % de la relacin calrica.
Protenas:
1,5g------------1kg/da
x-----------54kg
x = 81g de Protena.
Lpidos:
0,8g---------1kg/da
x----------54kg
x =43.2g de Lpidos.
CHO carbohidratos:
VIG= g CHO
Peso x1.44
2.5= = g CHO
54 x1.44
gCHO =2.5x54x1.44=1.94.40
gCHO =1.94.40g de Carbohidratos
=81g
6.25
=12.96gde N
RCNP=81
Los volmenes que se debe agregar tanto de macro micronutrientes yagua en
un esquema parenteral total.
Protenas
100mlsol 10% Aminoplasmal-------------10gproteina AA
X---------------81g protena
X =810ml
Lpidos
100ml------------20glipidos
X-----------43.2glipidos
X=216ml.
CHO dextrosa 50%
100ml----------50Gcho
X ---------194.4Gcho
X=388.8ml.
X=20.25mEq K. Potasio
110mEqK- 20.25mEq K =83.75mEq K
1ml de sol KCl 20%----------2.7mEq K
x--------------83.75mEq K
x=31ml de sol KCl 20%.
1ml de sol fosfato 15%----------1mEq K
x--------------20mEq K
x=20ml de sol 15%.fosfato
K=110mEqK-20.25+20
K=110-40.25 =69.75mEqK
K=69.75mEqK
1mlsol Kcl 20%-----------2.7mEqK
x--------------69.75mEq K
x=25.83ml de sol KCl 20%.
Requeriminto de Ca Gluconato
1ml de gluconato Ca----------0.46mEq Ca2+
x--------------10mEq Ca2+
x=21ml de gluconato Ca2+
Requerimiento de Magnesio Mg
. 1000ml Aminoplasmal ----------------5.22mEq Mg2+
810ml Aminoplasmal ----------------x
X=4.23mEq Mg2+
Mg2+=10-4.23=5.77mEq Mg2+
1ml sol MgS04 12.33%------------1mEq Mg2+
x--------------5.77mEq Mg2+
x=5.77mEq Mg2+
Volumen Final de Infusion VFI
VFI= V total
24h
= 2000 = 83.33ml
24
VFI =83.33ml/hora.
Balance Nitrogenado BN
BN=NI-NE
1000ml -----------------13.85g Urea
1950ml------------------x
X= 27g Urea.
Urea Urinara =Nitrogeno de Urea x0.467
=27x0.467
=12.6gN eliminado
NE=12.6+2=14.6
BN= NI-NE
=12.6-14.6
=1.64.
El paciente siempre pierde Nitrgeno a pesar que se le da una dieta
hirproteica
Vitamina NPT -----------------------10ml
Oligoelementos-----------------------10ml
Volumen total de Macro y micronutrientes
=1534.21
Volumen H20=Volumen Final-Volumen Macro y micronutrientes
=2000-1534.21
VH20 = 465.79ml.
G
kcal
%RC
-------------------------------------------------------------------4X Protena
81
324
23.5
-------------------------------------------------------------------9X
Lpidos
43.20
388.8
28.3
-------------------------------------------------------------------3.4X CHO
194.4
661
48.11
-------------------------------------------------------------------RCNP/N
. --------------------------------------------------------------------
-------------------------------------------------------------------------------------Nutrientes
gr
kcal
RC% RCNP/N VOLML
Omol
-----------------------------------------------------------------------------------------Protena
81 324 23.5
810
------------------------------------------------------------------------------------------CHO
194.4 661 48.11
388.8
------------------------------------------------------------------------------------------Lpido
43.20 28.3 28.3
216
-----------------------------------------------------------------------------------------TOTAL
1373.8
81
------------------------------------------------------------------------------------------BN
------------------------------------------------------------------------------------------Na+
20.9
------------------------------------------------------------------------------------------K+
31
------------------------------------------------------------------------------------------Ca++
21.77
------------------------------------------------------------------------------------------Mg++
5.77
------------------------------------------------------------------------------------------P
20
------------------------------------------------------------------------------------------Vit
10
------------------------------------------------------------------------------------------Olig
10
------------------------------------------------------------------------------------------TOTAL
153.1
------------------------------------------------------------------------------------------Agua
465.74
------------------------------------------------------------------------------------------TOTAL
-------------------------------------------------------------------------------------------
43.2
388.8
216
293
63288
CHO
194.4
660.9
388.8
2775
1078920
Na
20.2
6840
138168
16.25
4000
65000
Ca
21.7
697
151249
Mg
5.07
20,53
10408.7
33.3
1600
53280
-------------------------------------------------------------------------------------------