This document discusses parenteral nutrition, which involves delivering fluids, electrolytes, vitamins, minerals and other nutrients directly into the bloodstream intravenously. It notes that parenteral solutions provide daily fluid needs between 1500-2500 ml for most people and contain electrolytes like sodium, potassium, chloride, calcium and magnesium. The electrolyte content is expressed in mEq to indicate ionic charges. While vitamins, trace minerals and lipids are also included, medications are rarely added to avoid potential drug-nutrient interactions. The osmolarity of solutions is limited to 900 mOsm/L to protect peripheral veins.

2. Parenteral Nutrition
(Nutrients)
Course Code: HND-502
Course Title: Clinical and Therapeutic Nutrition
BS Human Nutrition and Dietetics
Dept. of Nutritional Sciences, GCUF
By
Dr. Huma Umbreen

3. Fluids and Electrolytes
• Fluids:
• Daily fluid needs approximate 30 to 40
milliliters per kilogram of body weight in
young adults and 30 milliliters per kilogram of
body weight in older adults (for a daily
average of between 1500 and 2500 milliliters
for most people).
• Adjustments are made according to fluid
losses and results of hydration assessment

4. Electrolytes
• The electrolytes added to parenteral solutions
include sodium, potassium, chloride, calcium,
magnesium, and phosphorus.
• Requirements for parenteral solutions differ from
DRI values because the nutrients are infused
directly into the blood and are not influenced by
absorption as they are when consumed orally.
• Generally, blood tests are administered daily to
monitor electrolyte status until patients have
stabilized.
• Electrolyte imbalances can be lethal, and
therefore electrolyte management by
experienced professionals is necessary whenever
intravenous therapies are used.

5. Cont….
• The electrolyte content of parenteral solutions
is expressed in milli equivalents (mEq), which
are units indicating the number of ionic
charges provided by electrolytes.
• The body’s fluids are neutral solutions that
contain equal numbers of positive and
negative charges

8. Vitamins and Trace Minerals
• Commercial multivitamin and trace mineral
preparations are routinely added to parenteral
solutions.
• All water-soluble vitamins are supplied, as well as
vitamins A, D, and E; vitamin K is often omitted and
must be added separately.
• Trace minerals added to parenteral solutions include
zinc, copper, chromium, selenium, and manganese.
Iron is excluded because it alters the stability of other
ingredients in parenteral mixtures; special forms of iron
need to be injected separately.

9. Osmolarity
• osmolarity of PPN solutions is limited to 900
milliosmoles per liter (because peripheral veins are
sensitive to high nutrient concentrations), whereas TPN
solutions may be as nutrient-dense as necessary.
• The components of a solution that contribute most to
its osmolarity are amino acids, dextrose, and
electrolytes: as concentrations of these nutrients
increase, the osmolarity of a solution increases.
• Because lipids contribute little to osmolarity, lipid
emulsions are used to increase the energy provided in
PPN solutions

10. Medications
• To avoid the need for a separate infusion site, medications
are occasionally added directly to parenteral solutions or
infused through a separate port (attached via a Y-
connector).
• The administration of a second solution using a separate
port in a catheter is called a piggyback. Insulin, for
example, is sometimes added by piggyback to improve
glucose tolerance.
• Heparin (an anticoagulant) may be added to prevent
clotting at the catheter tip.
• In practice, few medications are added to parenteral
solutions so that potential drug-nutrient interactions can be
avoided.