Question

A young man suffered third-degree burns over much of his body and is hospitalized in a severe catabolic state. An individual in this state requires about \(40 \mathrm{kcal}\) kg per day and \(2 \mathrm{g}\) protein kg per day to be in positive caloric and nitrogen balance. This young man weighs \(140 \mathrm{lb}\) \((64 \mathrm{kg}) .\) Total Parenteral Nutrition (TPN) is started with a solution containing \(20 \%\) glucose and \(4.25 \%\) amino acids (the form in which protein is supplied). If 3000 g of solution is infused per day, A. the patient would not be getting sufficient protein. B. the calories supplied would be inadequate. C. both protein and calories would be adequate to meet requirements. D. this is too much protein being infused.

Short answer

Answer: The patient would not be getting sufficient protein.

Step-by-step solution

Calculate the protein required daily for the patient

According to the information given, the patient requires 2g of protein per kg of body weight. The patient weighs 64 kg. To calculate the protein required daily for the patient, we can use the formula: Protein_required = Weight * Protein_per_kg Protein_required = 64 * 2 Protein_required = 128g The patient requires 128g of protein daily to maintain a positive nitrogen balance.

Calculate the caloric requirement daily for the patient

The patient requires 40 kcal per kg of body weight per day. To calculate the patient's daily caloric requirements, we can use the formula: Calories_required = Weight * Calories_per_kg Calories_required = 64 * 40 Calories_required = 2560 kcal The patient requires 2560 kcal daily to be in positive calorie balance.

Calculate the protein and calories supplied by the TPN solution

The protein (in the form of amino acids) in the TPN solution is 4.25% and glucose is 20%. The daily amount of TPN solution is 3000 g. To calculate the amount of protein and calories supplied: Protein_supplied = (TPN_daily * Protein_percentage) / 100 Protein_supplied = (3000 * 4.25) / 100 Protein_supplied = 127.5g Since proteins provide 4 kcal per gram, the calories provided by proteins are: Calories_proteins = Protein_supplied * 4 Calories_proteins = 127.5 * 4 Calories_proteins = 510 kcal To calculate the calories provided by glucose: Calories_glucose = (TPN_daily * Glucose_percentage * Calories_per_glucose_gram) / 100 Calories_glucose = (3000 * 20 * 4) / 100 Calories_glucose = 2400 kcal Total calories provided by the TPN solution are the sum of calories provided by proteins and glucose: Total_calories = Calories_proteins + Calories_glucose Total_calories = 510 + 2400 Total_calories = 2910 kcal

Compare the supplied protein and calories with the required amounts

Now, we will compare the supplied protein and calories with the required daily amounts: The patient requires 128g of protein daily, and the TPN solution provides 127.5g. This indicates that the patient's protein needs are almost met, but not quite sufficient (Option A). The patient requires 2560 kcal daily, and the TPN solution provides 2910 kcal. This indicates that the patient's caloric requirements are met and even exceeded (Option B is incorrect). Since both protein and calories are not entirely adequate, Option C is incorrect. Option D is also incorrect, as the protein amount is not excessive. Thus, the correct answer is: A. The patient would not be getting sufficient protein.