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the type of parenteral solution that should be administered depends on the patient’s
condition and metabolic needs and whether it will be given through a peripheral or central line. The solution usually contains protein, carbohydrates, electrolytes, vitamins, and trace
minerals. A lipid emulsion provides the necessary fat.
Parenteral solutions may contain the following elements, each offering a particular benefit:
dextrose-In parenteral nutrition solutions, most of the calories that can help maintain nitrogen balance come from dextrose. The number of nonprotein calories needed to maintain nitrogen balance depends on the severity of the patient’s illness. Dextrose provides 3.4 cal/g
amino acids-Amino acids supply enough protein to replace essential amino acids, maintain protein stores, and prevent protein loss from muscle tissue. Commercial
amino acid solutions range in concentration from 3% to 15%
fats-A concentrated energy source, fats prevent or correct fatty acid deficiencies. They’re available in several concentrations and can provide 30% to 50% of daily calories. Lipids
can be infused separately (as a lipid emulsion ) or mixed in with the carbohydrate and protein.
electrolytes and minerals-The amount of electrolytes and minerals added to the solution is based on evaluation of the patient’s serum chemisty profile and metabolic needs.
vitamins- To ensure normal body functions and optional nutrient use, the patient needs.
daily vitamins. A commercially available mixture of fat-and water-soluble vitamins, biotin, and folic acid may be added to the solution. Federal guidelines published in 2000 recommend that parenteral nutrition formulas contain vitamins A, D, C, E, K, and B12; thiamin; riboflavin; pyridoxine; niacin; pantothenic acid; folic acid; and biotin.
(The main changes from the previous guidelines are the addition of vitamin k and increased amounts of folic acid and vitamins C and B12 )
trace elements- Trace elements promote normal metabolism. Most commercial solutions contain zinc, copper, chromium, selenium, and manganese. Some peripheral nutrition formulas also contain sodium, potassium, chloride, acetate, phosphorus, magnesium, and calcium.
water – The amount of water added to a parenteral nutrition solution depends on the patient’s fluid requirements and electrolyte balance.