Patient Encounter 4

The surgical team plans to initiate PN for AA as you have recommended. Propofol was initiated and the rate titrated for AA adequate sedation. Laboratory data were listed previously.

What other laboratory data or monitoring parameters should be obtained before initiating PN?

How frequently should you monitor each of the various parameters after initiating

What potential complications of PN should you monitor for in AA?

What approaches should be undertaken to prevent and treat hyperglycemia in AA?

How should the PNformulation be adjusted followingpropofol initiation in AA?

Table 100-7 Suggested Frequency of Monitoring Parameters in Hospitalized Patients Receiving PN

Pmniilin

Enttftl

M x WttH/ (£UUi}

Wr»kfy

At Indicated

libod'.jr.i iiii roQrtt, c nauinine

X

X

X

Scdiwp, pcKanium, chtoiide, bicarbonate

X

X

X

CiHwe

X

X

X

Cjic ¡urn, phosphoius. nriagneiium

X

X

X

Albumin, ;K{iMtal*> aminatramiPMM1,

alanine aminotransferase, lac late

tie hytrroi)?fiaw, ¿1^ ne pboiiihaiaw,

total bilirubin

Conjur>)K(1 bilirubin

X

X

Ptfjlburniri

X

X

Tiigtjceildes

X

X

X

tad wcoditii cowflj rtmoy lobirv

X

X

hematocril, white blood rHI counf

± difrcfcriLial. ptoldels, p-jrlktl

ihrombcfiiilln lime

PKXhrombir» Ihrnalmernjlioral

X

ncrrnjftjpd tjfiri

Nitiogwi bjlaricc-

X

Tint «tenlum.clKomium, coppei,

X

manganese. Iron

Total ¡¡on binding capacity, (nritin

X

Wamin concflfvmrioni

X

Ammonia

X

Sfcxid culture?

X

fcxty weigN

X

X

X

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