TPN & Hemodynamic Monitoring

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Author:
brandikh
ID:
268908
Filename:
TPN & Hemodynamic Monitoring
Updated:
2014-04-02 08:01:11
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TPN Hemodynamic Monitoring
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TPN & Hemodynamic Monitoring
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  1. blood pressure within the arterial system. Blood flow
    is positively affected by arterial pressure;
    any factor decreasing arterial
    blood pressure decreases arterial blood
    flow
    arterial blood pressure
  2. represents the average arterial pressure
    during the cardiac cycle
    mean arterial pressure (MAP)
  3. The pressure created by the volume
    of fluid returning to the right atrium and ventricle is a measure of right
    ventricular function and is often
    used as a guide to overall fluid
    management
    central venous pressure (CVP)
  4. This is the amount of blood pumped
    out of the ventricles by each beat or
    stroke of the heart.
    STROKE VOLUME
  5. The volume of blood pumped by the
    left ventricle per minute is determined
    by multiplying stroke volume and
    heart rate.
    cardiac output
  6. This calculated value is comprised
    of the cardiac output divided by body
    surface area.
    cardiac index
  7. indications for monitoring intra-arterial BP
    • indicated for any condition
    • in which cardiac output, tissue perfusion,
    • or fluid volume status may be
    • compromised.
  8. 3 types of shock & describe
    • hypovolemic:  inadequate fluid in the intravascular space
    • cardiogenic:  heart fails to pump blood effectively
    • septic shock:  microorganisms have invaded the body
  9. TPN:  total calories for normal, min & max
    • 25-35 kcal/kg
    • min: 10 kcal/kg (for morbid obesity)
    • max: 45-55 (severe malnutrition)
  10. TPN: total protein for normal, min & max
    • 0.8-1.5 g/kg (but hospitalized pts usually need 1.5-2.0 g/kg, & critically ill pts who are receiving continuous venovenous hemodialysis may need up to 2.0 g/kg)
    • min: .8
    • max: 2.5
  11. TPN: total fat for normal, min & max
    • 25-30% of kcal
    • min: 10% as commercial IV fat emulsion
    • max: 30%
  12. TPN: total fluid needs for normal, min & max
    • 30-40 mL/kg
    • min: as per compatiblity/osmolarity guidelines
    • max: variable depending upon fluid losses

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