# Tube Feedings

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EN: Water Flush

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### 12 Terms

1

EN: Water Flush

EN: kcal - FW = mL of water flush

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2

Enteral Tube Feedings

1. Calculate estimated needs CHO, Protein, Fluid

2. Select TF formula

3. Choose caloric level starting point

4. How much TF to meet caloric needs

1. Example: 1400 desired kcals / 1.2 kcals/ml  = 1167 ml formula needed

5. See if CHO, Protein, & Fat will meet pt needs

Convert TF from ml into L

1. Multiply L of TF with Protein (g)

6. Determine rate of TF

7. Determine free water in TF

1. mL of water in TF / 1000 = %

2. mL of TF (#6 rounded) * #7a. = mL free water delivered in x ml of formula

8. Amount additional water is needed to meet estimated fluid needs

1. x ml fluid needed – x (#7b) ml free water in TF = x ml additional free water needed

2. Divide the free water

1. BID | TID | QID

9. Write final TF order

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3

TPN: Lipid solutions

1.1 @ 10% OR 2 @ 20%

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4

TPN: Protein

4

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5

TPN: CHO

3.4

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6

TPN: Fat

10

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7

3 in 1 —> D15%, AA4.25%, IL3.2% at 70ml/hr.

volume of TPN = 1680ml

grams / kcal from CHO = 252gCHO / 856.8kcal

grams / kcal of protein = 71.4g AA / 285.6kcal

grams / kcal for IL = 53.76g IL / 537.6kcal

total kcal = 1680kcal

CHO Infusion rate = 252g CHO ÷ 79kg (pt weight) ÷ 1440 (min/day) x 1000 (mg/g) = 2.2mg/kg/min

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8

TPN: CHO Infusion

Measures how much CHO is oxidized

g CHO ÷ kg (pt weight) ÷ 1440 (min/day) x 1000 (mg/g) = mg/kg/min

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9

TPN: 2 in 1 — > D25%, AA5.5% at 50ml/hr. 10% IL at 10ml/hr x 12 hr

volume of dextrose/AA solution = 1200ml/d

grams / kcal from CHO = 300g CHO / 1020kcal

grams / kcal of protein = 66g AA / 264kcal

volume / kcal /grams of IL = 120 mL / 132kcal / 13 gm

Total: 1416kcal/d

CHO infusion rate = 300g CHO ÷ 58kg (pt weight) ÷ 1440 (min/day) x 1000 (mg/g) = 3.6mg/kg/min

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10

TPN: Dual Chamber Bag = Fat in upper chamber & dextrose and AA in lower

D20%, AA5%, 150ml 20% IL at 65ml/hr

volume of TPN = 1560ml/d

grams / kcal from CHO = 282g CHO / 959kcal

grams / kcal of protein = 70g AA / 280kcal

kcal /grams of IL = 300kcal / 30 gm

Total: 1539kcal/d

CHO Infusion rate: 282g CHO ÷ 79kg (pt weight) ÷ 1440 (min/day) x 1000 (mg/g) = 2.5mg/kg/min

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11

TPN: Initial Concentration —> 420ml D70, 700ml AA 15%, 200ml 20% IL

grams / kcal from CHO = 294g CHO / 1000kcal

grams / kcal of protein = 105g AA / 420kcal

kcal /grams of IL = 400kcal / 40 gm

Total: 1820kcal/d

CHO infusion rate: 294g CHO ÷ 84kg (pt weight) ÷ 1440 (min/day) x 1000 (mg/g) = 2.4mg/kg/min

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12

TPN: Propofol

1.1kcal/ml

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