TPN STUDY GUIDE QUESTIONS AND
CORRECT ANSWERS.
TPN Ingredients
1) dextrose
2) amino acids
3) lipids
4) electrolytes
5) vitamins/minerals
Purpose of TPN
1) prevent catabolism
2) prevent essential fatty acid deficiency
3) improve growth
By improving growth with TPN, we are able to optimize nutrient intake, which serves as a
bridge in VLBW (<1500 gram) preterm infants in whom enteral feeds/nutrition is unlikely
to be achieved within the first 3 - 5 days.
Difference between "NPO volume" and "Adjusted volume"
The "NPO volume" is the volume used by pharmacy to compound the PN, assuming zero oral
intake, ensuring adequate nutrition and hydration even if the neonate cannot feed orally. The
"adjusted volume" accounts for other fluid sources and is used to calculate the PN infusion rate.
Extremely premature neonates (<1000 gram) may require higher fluid amounts (e.g., 130-
150 mL/kg/day for those < 1500 g) due to increased insensible water loss from their
immature skin and kidneys. Fluid needs are generally higher for preterm infants compared
to term infants.
Day 1 TPN electrolytes for the most part require _____ to ______ mEq/kg __________
_______________ and ___ - ____ mEq/kg/day of ___________ ____________.
Day 1 TPN electrolytes for the most part require 0.5 - 1 mEq/kg sodium phosphate and 1 - 1.5
mEq/kg/day of calcium gluconate.
, Stock TPNs should ONLY be used on ________ _____ or if a TPN needs to be ____-
______________ at a later date (eg ______________ ________________ which may require
bowel rest for a few days).
Stock TPNs should ONLY be used on Day 0 or if a TPN needs to be re-initiated at a later date
(eg necrotizing enterocolitis which may require bowel rest for a few days).
Also, unless you want to give excessive protein and overdose on calcium and cause
arrhythmias when starting a stock TPN on Day 0 it's probably best to keep the limit to
_______________ Actually, make sure that happens! If your baby needs more fluid, this is
when we can _________ some __________ or _________ to make up your total fluid goals.
Also, unless you want to give excessive protein and overdose on calcium and cause arrhythmias
when starting a stock TPN on Day 0 it’s probably best to keep the limit to 100 mL/kg/day.
Actually, make sure that happens! If your baby needs more fluid, this is when we can y-
site some D10W or D5W to make up your total fluid goals.
Dextrose 10% 250 mL bags should be floor stock in your NICU if it isn't already - this will
save you a lot of delays to administration as they might also use this for
___________________ management.
Dextrose 10% 250 mL bags should be floor stock in your NICU if it isn’t already - this will save
you a lot of delays to administration as they might also use this for hypoglycemia management.
Most tiny humans at Level II NICU's (Gestational Age of 32weeks 0 days) and 9.99 times
out of 10 will be just fine starting gavage feeds and D10W via peripheral line (maximum of
straight D12.5W via peripheral if needed).Don't send them a 1000mL bag! We don't need
to create more room for errors or waste a lot of extra fluid on these kiddo's, all pre-mixed
fluid orders for the NICU should be maxed at ________.
Most tiny humans at Level II NICU’s (Gestational Age of 32weeks 0 days) and 9.99 times out of
10 will be just fine starting gavage feeds and D10W via peripheral line (maximum of straight
D12.5W via peripheral if needed).Don’t send them a 1000mL bag! We don’t need to create more
room for errors or waste a lot of extra fluid on these kiddo’s, all pre-mixed fluid orders for the
NICU should be maxed at 250 mL.
CORRECT ANSWERS.
TPN Ingredients
1) dextrose
2) amino acids
3) lipids
4) electrolytes
5) vitamins/minerals
Purpose of TPN
1) prevent catabolism
2) prevent essential fatty acid deficiency
3) improve growth
By improving growth with TPN, we are able to optimize nutrient intake, which serves as a
bridge in VLBW (<1500 gram) preterm infants in whom enteral feeds/nutrition is unlikely
to be achieved within the first 3 - 5 days.
Difference between "NPO volume" and "Adjusted volume"
The "NPO volume" is the volume used by pharmacy to compound the PN, assuming zero oral
intake, ensuring adequate nutrition and hydration even if the neonate cannot feed orally. The
"adjusted volume" accounts for other fluid sources and is used to calculate the PN infusion rate.
Extremely premature neonates (<1000 gram) may require higher fluid amounts (e.g., 130-
150 mL/kg/day for those < 1500 g) due to increased insensible water loss from their
immature skin and kidneys. Fluid needs are generally higher for preterm infants compared
to term infants.
Day 1 TPN electrolytes for the most part require _____ to ______ mEq/kg __________
_______________ and ___ - ____ mEq/kg/day of ___________ ____________.
Day 1 TPN electrolytes for the most part require 0.5 - 1 mEq/kg sodium phosphate and 1 - 1.5
mEq/kg/day of calcium gluconate.
, Stock TPNs should ONLY be used on ________ _____ or if a TPN needs to be ____-
______________ at a later date (eg ______________ ________________ which may require
bowel rest for a few days).
Stock TPNs should ONLY be used on Day 0 or if a TPN needs to be re-initiated at a later date
(eg necrotizing enterocolitis which may require bowel rest for a few days).
Also, unless you want to give excessive protein and overdose on calcium and cause
arrhythmias when starting a stock TPN on Day 0 it's probably best to keep the limit to
_______________ Actually, make sure that happens! If your baby needs more fluid, this is
when we can _________ some __________ or _________ to make up your total fluid goals.
Also, unless you want to give excessive protein and overdose on calcium and cause arrhythmias
when starting a stock TPN on Day 0 it’s probably best to keep the limit to 100 mL/kg/day.
Actually, make sure that happens! If your baby needs more fluid, this is when we can y-
site some D10W or D5W to make up your total fluid goals.
Dextrose 10% 250 mL bags should be floor stock in your NICU if it isn't already - this will
save you a lot of delays to administration as they might also use this for
___________________ management.
Dextrose 10% 250 mL bags should be floor stock in your NICU if it isn’t already - this will save
you a lot of delays to administration as they might also use this for hypoglycemia management.
Most tiny humans at Level II NICU's (Gestational Age of 32weeks 0 days) and 9.99 times
out of 10 will be just fine starting gavage feeds and D10W via peripheral line (maximum of
straight D12.5W via peripheral if needed).Don't send them a 1000mL bag! We don't need
to create more room for errors or waste a lot of extra fluid on these kiddo's, all pre-mixed
fluid orders for the NICU should be maxed at ________.
Most tiny humans at Level II NICU’s (Gestational Age of 32weeks 0 days) and 9.99 times out of
10 will be just fine starting gavage feeds and D10W via peripheral line (maximum of straight
D12.5W via peripheral if needed).Don’t send them a 1000mL bag! We don’t need to create more
room for errors or waste a lot of extra fluid on these kiddo’s, all pre-mixed fluid orders for the
NICU should be maxed at 250 mL.
