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1st RNY with TPN!!!!

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I have my very first post-op RNY with tpn right now and I have

absolutely no clue what to do. It's been years since I've seen a tpn!

Pharmacy has taken care of everything but I want to make sure I am

checking it right.

Pt is 12 days post-op readmitted with a leak. TPN providing 2150

kcal/d and 95g protein. Is this too many cals or do I need to worry

about that? She also has had diarrhea since tpn started 2 days ago.

She's receiving all vits and minerals needed except for B12. I did

recommend adding that to the mixture.

I'm not sure how long she will be on tpn. Can anyone give me some

ideas of what to keep an eye on or any recommendations I might give to

the pharmacist?

Thanks!

, RD

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What are your estimated needs? We usually do 20 kcal/kg adjusted weight and

1.5gm/kg protein so I'm thinking the protein may be a little low but

without a ht/wt it is difficult to tell. Watch electrolytes especially

phosphorus and magnesium closely. I would do daily until stable and then

M-W-F. B12 can be added to the TPN. Vitamins and minerals should not be a

problem on TPN since they are added directly to the TPN.

Rita , RD, LD/N

Clinical Nutrition Manager

Memorial Hospital of Tampa

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07/10/06 03:34 PM RNY with TPN!!!!

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I have my very first post-op RNY with tpn right now and I have

absolutely no clue what to do. It's been years since I've seen a tpn!

Pharmacy has taken care of everything but I want to make sure I am

checking it right.

Pt is 12 days post-op readmitted with a leak. TPN providing 2150

kcal/d and 95g protein. Is this too many cals or do I need to worry

about that? She also has had diarrhea since tpn started 2 days ago.

She's receiving all vits and minerals needed except for B12. I did

recommend adding that to the mixture.

I'm not sure how long she will be on tpn. Can anyone give me some

ideas of what to keep an eye on or any recommendations I might give to

the pharmacist?

Thanks!

, RD

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