26
81 ................................................................. ............................ ............................. .................................................................. 1.1 1.2 ()............................... 1.3 1-2 >2-3 >3-4 >4 1.4 / / () ............................................................. 1.5

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Page 1: ˇ˘ ˇ ˛ !˘ !˘ #˚˙ˇ˛$%! ˛&!ˇ ˇkb.psu.ac.th/psukb/bitstream/2553/1852/2/286517_app.pdf · Amino acid (Standard AA Infant) 3.00 g Volume 100.00 ml NaCl 4.00 mM Na acetate

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�� �������� ����������������� ���

�������������� ���!���!"���#������$%��!��&!������ ��

����������� .................................................................�������� ............................ ��� ............................�.����������� ..................................................................

1.1 �������

� � !" �#�" � �#�" �$��%�

� ���$&! � #"'�

1.2 �%)*&!+�&�����%,

� -!*..�!� � -!*../�

� -!*..��& � ����$��"�$.�0#1��(!1'%)...............................

1.3 -!1�'&!� �&��"�&�'&!����!��!�����,��5�,� 1-2 -7 � >2-3 -7

� >3-4 -7 � >4 -7

1.4 ���:,�;��!���&��"�&�'&!����!��!�����,��5�, &������,

� &�����!�"� � &-!1�'&!� &!����

� &&!�<�!���-!1$%��*$&!/ �'!�/ �����

� �5�� > (!1'%) .............................................................

1.5 �����;����@��� '����� �����(������������ ���!���!"���#�) ��-A %'��

� ,��&����%, � ,��& � ,�-�&�� � ,����" � ,����"����%,

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82

1.6 <��,�<�� '����� �����(������������ ���!���!"���#�) ��-A %'��......................................................................................................CCCCCC..C.......CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC....C......................................................................................................CCCCCC..C.......CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC....C......................................................................................................CCCCCC..C.......CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC....C......................................................................................................CCCCCC..C.............................................................................................................CCCCCC..C.......

1.7 -A.��%-�!!;<�� '����� �����(������������ ���!���!"���#�) ��-A %'��......................................................................................................CCCCCC..C.......CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC....C......................................................................................................CCCCCC..C.......CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC....C......................................................................................................CCCCCC..C.......CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC....C......................................................................................................CCCCCC..C.............................................................................................................CCCCCC..C.......

1.8 <��������1/<��;�!-!�'-!%�<�� '����� �����(������������ ���!���!"���#�)��-A %'��......................................................................................................CCCCCC..C.......CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC

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83

C....C......................................................................................................CCCCCC..C.......CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC....C......................................................................................................CCCCCC..C.......CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC....C......................................................................................................CCCCCC..C.............................................................................................................CCCCCC..C.......

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84

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�������+�$ %�� "(��!���!"������� Order PN

l

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85

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�������+�3��� �#����$ %���(� PN ����4��5�%�4���6�

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86

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�������+�3��� �#����$ %���(� PN ����4��5�%����

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87

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����%��� Adult PN Doctor Order Sheet for One Day

15 �*". 49 TPN ���!������ (15-06-49) Rate 80 ml/hr 07: 46 �. ���!�'�$������� 15-06-49

Dextrose 50% 500.00 mlAmino (Standard AA)NaClNa_acet

500 ml40.00 mEq40.00 mEq

K2HPO4 40.00 mEqK-acetate 30.00 mEqMgSO4 8 mEqCa 10 mlMVI 4.00 (ml /day)TE 1.00 mlRI 30.00 unitZn 2.50 mg

14 �*". 49 TPN ���!������ (13-06-49) Rate 80 ml/hr 07: 46 �. ���!�'�$������� 14-06-49

Dextrose 50% 500.00 mlAmino (Standard AA) 500.00 mlK2HPO4 40.00 mEqK-acetateMgSO4Ca

30.00 mEq8.00 mEq10 ml

MVI 4.00 (ml /day)TE 1.00 mlRI 30.00 unitZn 2.50 mg

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88

������� & 5

����%��� Pediatric PN Doctor Order Sheet for One Day

15 �*". 49 TPN ���!������ (15-06-49) Rate 30 ml/hr 08: 24 �. ���!�'�$������� 15-06-2549

20% Lipid 36.50 ml Vitalipid 10.00 ml IV Drip 24 hrDextrose 20% 20.00 gAmino acid (Standard AA Infant) 3.00 gVolume 100.00 mlNaCl 4.00 mMNa acetate 3.00 mMNa 7.00 mMK2HPO4 0.25 mMK 0.5 mMCl 4.00 mMAcetate 3.00 mMP 0.25 mMCa 0.3 mMMg 0.25 mMZn 300 mcgTE 0.1 mlLipid 1.00 gEnergy 90.00 kcalNPC : N 162.50 : 1Heparin 100.00 unitSoluvit 1.00 mlVitalipid 1.37 ml

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89

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�������+����(����I% PN �#�����4��5�%�4���6� I(����J������/L����

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90

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�������+����(����I% PN �#�����4��5�%���� I(����J������/L����

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91

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&����!������I I( I��� +#���O���������4�� PN

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92

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Adult PN working formula �#��������J��

��I%� _____ ���4��5�% ______��� I(��(����I% ________Bottle No. _________

HN ________ Name ________________________

Parenteral Nutrition 1,000 ml

D50W: 500.00 ml

AA: STD 500.00 ml

NaOAc 14.83 ml NaCl 14.99 ml

KCL 23.75 ml KOAc - ml

Ca 10.00 ml PO4 - ml

Mg 1.37 ml TE 1.00 ml

RI - ml MVI 4.00 ml

Vit C - ml Zn - ml

Vit Bco - ml WFI - ml

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93

������� & 10

Pediatric/ Neonatal PN working formula �#��������J��

��I%� _____ ���4��5�%________��� I(��(����I% ________ Bottle No. _________

HN _______ Name ________________________ (Wt________kg)

Total PN Vol 318 ml/bot Rate 12 ml/hr

D50W: 63.60 ml

AA: STD_P 47.70 ml

20%NaCl 1.40 ml NaOAc 1.10 ml

K2HPO4 3.18 ml KCl 2.40 ml

KOAC 0 ml Soluvit 3.18 ml

Hep 100 u/ml 1.59 ml Ped TE 0.32 ml

Zn 0.5mg/ml 1.91 ml 50%MgSO4 0.24 ml

10%Ca-glu 7.00 ml WFI 136.51 ml

20%Lipid 16.25 ml Vitalipid 10.00 ml

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94

������� & 11

Adult PN Label

��I%� ______ ���4��5�% ________��� I(��(����I% ________ Bottle No. ________HN _______ Name______________________________Parenteral Nutrition 1,000 ML. Rate 40 ml/hrNaCl 100.00 mEq Amino 50.00 gNa_acet 20.00 mEq Nitrogen 8.00 gK2HPO4 0 mEq Dextrose 250.00 gKCl 30.00 mEq Energy 1250.00 KcalK_acet 30.00 mEq NPC: N 131.25 :110%Ca 10.00 ml TE 1.00 ml50%MgSO4 8.00 mEq Zn - mgMVI 4.00 ml/day RI - unitVit C - ml Vit Bco - ml

���I% ��%...............................................................DO NOT USE AFTER: 06-06-2549 Time : 16.30 �.

(� "(� #�!�%��s��t����� I(+u�&��!����� �v�%���%�� 24 J .)

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95

������� & 12

Pediatric/ Neonatal PN Label

��I%� _____ ���4��5�% _______��� I(��(����I% _________ Bottle No. _________HN _____ Name ______________________________ (Wt 7.5 kg)Total PN Vol 990.00 ml/bot Rate 40 ml/hrPer Kg. BW ���I% ��% ...................................................................................Na 4.00 mM Volume 120.00 mLK 2.40 mM Dextrose 20 % 24.00 gP 0.20 mM Amino acid 3.00 gCl 3.00 mM Lipid 0.50 gAcetate 3.00 mM Energy 98.60 KcalCa 0.50 mM NPC: N 180.42 :1Mg 0.15 mM Heparin 120.00 unitZn 300 mcg Soluvit 1.00 mlTE 0.10 ml Vitalipid 1.33 mlDO NOT USE AFTER : 06 w 06 -49 Time : 16.30 �.

(� "(� #�!�%��s��t����� I(+u�&��!�� ��� �v�%���%�� 24 J .)

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96

������� & 13

��� Fat Emulsion Label I(�&I%����%!�% "� (��xI manual)

20% Fat Emulsion 16.25 ml.

+ Vitalipid 10.00 ml. ��� I(���I% ____________

J"(��4��5�% ____________________ Ward____________

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97

������� & 14

��� PN working formula I(L�������+�����������%��xI manual

��I%� _____ ���4��5�%______��� I(��(����I% ________ Bottle No. _________

HN _______ Name ________________________ (Wt________kg)

Total PN Vol 318 ml/bot Rate 12 ml/hr

D50W: 63.60 ml

AA: STD_P 47.70 ml= 111.30 ml

20%NaCl 1.40 ml NaOAc 1.10 ml

......................................................................................................................................

......................................................................................................................................

......................................................................................................................................

......................................................................................................................................

.....................................................................................................................................

!��-!*��!D50W ��1Amino acid�#5���!� ��'!1����&!

��!�"�

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98

������� & 15

��� PN Label I(L�������+�����������%��xI manual

��I%� ______ ���4��5�% _______��� I(��(����I% ________ Bottle No. ________HN _______ Name______________________________................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

���I% ��%.........................................................DO NOT USE AFTER: 06-06-2549 Time : 16.30 �.

(� "(� #�!�%��s��t����� I(+u�&��!����� �v�%���%�� 24 J .)

���$&!�����!�"� PN�s@�$5����$�����t

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99

������� & 16

����"��$%, Sticker ���!�'#*�# Label,

(���� PN label)

DO NOT USE AFTER: CCCCCCC. Time : 16.30 �.(��5�����"���&-y��&����� %&<�,����;�!�$�""�� 24 $�.)

(���� working formula)

(���� IV lipid emulsion)20% Lipid EmulsionCC ml. + Vitalipid CCCCml+ Soluvit CCC. ml ������CCCCCCC$5�����-{�"............................HNCCCCC. WardCCC

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100

������� & 17

����%�������+�3��� �#������(� PNHN________________Name_______________ Bed _______Ward_____________________

Date (PN Day)

Enteral (ml)TPN + Lipid (ml)Total Fluid (ml)

Enteral (Kcal)TPN + Lipid (Kcal)Total Energy (Kcal)

PN Formula

PN Volume (ml)Dextrose (%)Protein (g)Lipid (g)Energy (Kcal)NPC : N

Electrolytes

NaCl Na acetateNa KCl K acetate K2HPO4KClPCaMgZnTrace element

Page 21: ˇ˘ ˇ ˛ !˘ !˘ #˚˙ˇ˛$%! ˛&!ˇ ˇkb.psu.ac.th/psukb/bitstream/2553/1852/2/286517_app.pdf · Amino acid (Standard AA Infant) 3.00 g Volume 100.00 ml NaCl 4.00 mM Na acetate

101

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�������%�������� $� $�{�� |!�� !� working formula

�����(�$� $�{�� |!��

�#*�# ��t���, �#*�# '�����

� ����0�& PN <�,��� 1 � ����0�& PN <�,��� 2 � ����0�& PN <�,��� 3� working formula <�,���1 � working formula <�,���2 �working formula <�,���3

� ����0�& IV Lipid Emulsion

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102

������� � 1

Calcium wPhosphate Solubility Curve for Aminosteril

(#5t������,��<�<������&!~'��'�&���&!�&*,&!�&�1&��<���;��s�"���1~���~� � ;���<��<��<���!�1�"&!,�1�*/���t� >)

Calcium (mmol/L)

Phosphate (mmol/L)

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103

������� � 2

Calcium wPhosphate Solubility Curve for Aminosol

(#5t������,��<�<������&!~'��'�&���&!�&*,&!�&�1&��<���;��s�"�

Phosphate (mmol/L)

30

25

20

15

10

5

00 10 20 30

Calcium (mmol/L)

Aminosol 1, 3, 5%

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104

��1~���~� � ;���<��<��<���!�1�"&!,�1�*/���t� >)

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105

������� � 3

Calcium wPhosphate Solubility Curve for Aminoven Infant

0 10 20 30Calcium (mmol/L)

Phosphate (mmol/L)

30

20

10

0

(From left to right)

Aminoven- Infant

1, 3, 5%

(#5t������,��<�<������&!~'��'�&���&!�&*,&!�&�1&��<���;��s�"���1~���~� � ;���<��<��<���!�1�"&!,�1�*/���t� >)

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106

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����� I(���!�!�% I(�J��� PN

���!�!�% ��� �����+u���ampoule/ bottle/ vial ����� I(���!�!�%

Amino acid children 10% 500 1/500 = 0.002Amino acid High EAA 250 1/250 = 0.004Amino acid HighBCAA 500 1/500 = 0.002Amino acid Infant 10% 100 1/100 = 0.01Amino acid standard 10% 500 1/500 = 0.002Ca-gluconate 10% 10 1/10 = 0.1Dextrose 50% 500 1/500 = 0.002Heparin 100 u/ml 10 1/10 = 0.1K acetate 3 mM/ml 20 1/20 = 0.05K2HPO4 8.71 % 20 1/20 = 0.05KCl 40 mEq/20ml 20 1/20 = 0.05Lipid emulsion 20% 500 1/500 = 0.002MgSO4 50% 2 1/2 = 0.5MVI adult 4 1/4 = 0.25Na acetate 3 mM/ml 20 1/20 = 0.05NaCl 20% 200 1/200 = 0.005Regular insulin 100 u/ml 10 1/10 = 0.1Soluvit 10 1/10 = 0.1Trace element Adult 10 1/10 = 0.1Trace element Ped 10 1/10 = 0.1Vitalipid 10 1/10 = 0.1ZnSO4 10 1/10 = 0.1