Mr. Blair, a 75-year-old man weighing 60 kg, was admitted to the Gastroenterology Unit of the Miracle Hospital with severe diarrhea due to food poisoning. After examining Mr. Blair, Dr. Clark ordered IV fluids of D5W 1000 mL q12h, for the next three days with added electrolytes, such as potassium, sodium, calcium, and magnesium, since Mr. Blair was severely dehydrated. In addition, suspecting Salmonella poisoning, Dr. Clark prescribed Septra, 500 mg IV q12h, to be mixed in the D5W electrolytes fluid admixture. What considerations must be taken into account prior to admixing this order? (NAPRA 6.1, 6.2, 8.3, 9.2) 2.If the drug is determined to be incompatible with D5W and electrolytes, what IV delivery system and/or administration method would you use to administer the medication? (NAPRA 2.3, 6.1, 6.2, 8.3, 9.2) 3.What would be the infusion rate of the drug admixture in millilitres per hour and drops per minute when a primary IV administration set was used with a drop factor of 10 drops/mL? (NAPRA 3.1) 4.What is the dose rate of Septra in mg/kg/hr? (NAPRA 3.1) Case Study Ensuring Appropriateness of a Parenteral Nutrition Order Stephen is a 45-year-old male suffering from Crohn’s disease. In the last month, he had been having severe inflammatory attacks and losing weight because of inability to eat. He was admitted to the hospital’s GI unit. The GI specialist decided to put him on parenteral nutrition for a short period to rest the bowel and alleviate the inflammation while providing necessary nutritional support. At the time of admission, Stephen weighed 50 kg and looked dehydrated. The GI specialist prescribed the following order for a period of 24 hours: Protein Dextrose Fat Sodium chloride Potassium chloride Potassium phosphate Magnesium sulphate Calcium gluconate Trace elements mix (copper, zinc, chromium, manganese, selenium, iodide) Multivitamins Sterile water for injection qs ad 50 g 350 g 100 g 140 mmol 90 mmol 8 mmol 8 mmol 8 mmol 1 mL 1 mL 2000 mL How would the protein and fat be provided in the parenteral nutrition admixture? (Napra 3.1, 3.3, 6.1, 6.2) 2.How many nonprotein calories is Stephen receiving per day? (Napra 3.1, 3.3, 6.1, 6.2) 3.How would this type of parenteral nutrition solution be administered? (Napra 3.1, 6.1, 6.2) 4.What would be the order of mixing the components to avoid possible incompatibilities? (Napra 3.2, 3.3, 6.1, 6.2, 9.2)
Case Study Identifying Intravenous Delivery Systems, Administration Method, Infusion Rate, Stability/Compatibility, and Labelling of an Intravenous Admixture
Mr. Blair, a 75-year-old man weighing 60 kg, was admitted to the Gastroenterology Unit of the Miracle Hospital with severe diarrhea due to food poisoning. After examining Mr. Blair, Dr. Clark ordered IV fluids of D5W 1000 mL q12h, for the next three days with added electrolytes, such as potassium, sodium, calcium, and magnesium, since Mr. Blair was severely dehydrated. In addition, suspecting Salmonella poisoning, Dr. Clark prescribed Septra, 500 mg IV q12h, to be mixed in the D5W electrolytes fluid admixture.
- What considerations must be taken into account prior to admixing this order? (NAPRA 6.1, 6.2, 8.3, 9.2)
2.If the drug is determined to be incompatible with D5W and electrolytes, what IV delivery system and/or administration method would you use to administer the medication? (NAPRA 2.3, 6.1, 6.2, 8.3, 9.2)
3.What would be the infusion rate of the drug admixture in millilitres per hour and drops per minute when a primary IV administration set was used with a drop factor of 10 drops/mL? (NAPRA 3.1)
4.What is the dose rate of Septra in mg/kg/hr? (NAPRA 3.1)
Case Study Ensuring Appropriateness of a Parenteral Nutrition Order
Stephen is a 45-year-old male suffering from Crohn’s disease. In the last month, he had been having severe inflammatory attacks and losing weight because of inability to eat. He was admitted to the hospital’s GI unit. The GI specialist decided to put him on parenteral nutrition for a short period to rest the bowel and alleviate the inflammation while providing necessary nutritional support. At the time of admission, Stephen weighed 50 kg and looked dehydrated. The GI specialist prescribed the following order for a period of 24 hours:
|
Protein Dextrose Fat Sodium chloride Potassium chloride Potassium phosphate Magnesium sulphate Calcium gluconate Trace elements mix (copper, zinc, chromium, manganese, selenium, iodide) Multivitamins Sterile water for injection qs ad |
50 g 350 g 100 g 140 mmol 90 mmol 8 mmol 8 mmol 8 mmol 1 mL 1 mL 2000 mL |
- How would the protein and fat be provided in the parenteral nutrition admixture? (Napra 3.1, 3.3, 6.1, 6.2)
2.How many nonprotein calories is Stephen receiving per day? (Napra 3.1, 3.3, 6.1, 6.2)
3.How would this type of parenteral nutrition solution be administered? (Napra 3.1, 6.1, 6.2)
4.What would be the order of mixing the components to avoid possible incompatibilities? (Napra 3.2, 3.3, 6.1, 6.2, 9.2)
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