A 14.8 kg patient is receiving: D5 ¼ NS + 20 mEq/L KCl @ 20 mL/hr...

A 14.8 kg patient is receiving:

D5 ¼ NS + 20 mEq/L KCl @ 20 mL/hr

Heparin 1unit/mL in NS at 2 mL/hr

Insulin 1 unit/mL in NS at 1 mL/hr

How many mEq/kg/day of sodium is the patient receiving

Solutions

Expert Solution

NS is 0.9% NaCl i.e. 0.9 g in 100 ml or 9 g in 1000 ml

Moles of NaCl = 9.0 g/L/58.5 g/mol = 0.154 mol/L or 154 mmol/L

Equivalents of NaCl = moles of NaCl = 154 mEq/L or 0.154 mEq/ml

Total NS in an hour = 2 ml (for heparin) + 1 ml (for insulin) = 3 ml/hour

So, mEq of NaCl delivered per hour

= 3 ml*0.154 mEq/ml = 0.462 mEq

D51/4NS means 5% dextrose in 1/4 NS (i.e. 0.225% NaCl)

mEq of NaCl in 1/4 NS = 1/4*(0.154 mEq/ml) = 0.0385 mEq/ml

mEq of NaCl delivered with D5

= 20 ml*0.0385 mEq/ml = 0.77 mEq

Total mEq of NaCl delivered in a hour

= (0.462 mEq + 0.77 mEq)

= 1.232 mEq

1 mEq of NaCl = 1 mEq of Na

Total mEq of Na per day = 1.232 mEq/h * 24 h

= 29.568 mEq/day

Mass of patient = 14.8 kg

mEq of Na per kg per day = 29.568 mEq/day ÷ 14.8 kg

= 1.997 mEq/kg/day

Answer: patient is receiving approx. 2.00 mEq/kg/day of Sodium.

queen_honey_blossom answered 1 year ago

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