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Monitoring The Patient On TPN

  1. Clinical Data To Be Checked Daily
    1. Patient’s sense of well being, symptoms suggesting fluid overload, high or low blood glucose.
    2. Patient’s strength as judged by graded activity, getting out of bed, walking stairs, climbing and weight measurement.
    3. Vitals; Temp. BP, PR, RR.
    4. Fluid balance: input vs. output.
    5. Delivery equipment of TPN nutrition.
  1. Laboratory Data To Be Monitored

Urine quantitation glucose

Four times daily

Blood Glucose, Na+, K+, Cl-, HCO3--, BUN

Daily until glucose infusion load & patient are stable.

S. albumin, Transferrin, LFT, S. creatinine, Ca++, PO4--, Mg++

Base line then twice weekly

Prothombin time

Base line then weekly


Nitrogen balance: N+ intake – (UUN + NUN).


UUN= Urine urea N+, NUN= Non urea and insensible losses.

  1. Indirect Calorimetery:
    To find out how the body is utilizing the caloric intake. It measures the respiratory quotient (RQ)
RQ > 1 Indirect Lipogenesis
RQ = 1 Carbohydrate Utilization
RQ= 0.74-0.85 Mixed fuel utilization.
RQ= 0.7 Fat utilization

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