Information on the order:
Pediatric/neonatal TPN parameters are automatically utilized for patients weighing less than 40 kg.
For MGH Pediatric TPN Guidelines, click More Info. Click OK to return to the order form.
If an active order for TPN exists, the new order form is populated with its values automatically. However, if you chose to change the weight for calculations when prompted, the volume and rate fields are reset to no entry.
The Total Daily Fluids displayed is a general care order. See Fluid Management Orders.
Complete the form:
If needed, complete the Calculate section by entering the appropriate value in one of the following fields:
Total Volume (ml) of TPN to be delivered in Total Time indicated.
Rate of infusion (ml/hr) for constant rate over Total Time indicated.
Variable rate over 24 hours: Click Cycling Rates (ALT+Y). Type the ml/hr and duration for each cycle, totaling 24 hrs. Click OK (ALT+O).
Volume per kilogram of weight per day (ml/kg/day).
If you enter Total Volume, the dependent values are calculated automatically as you type. Press TAB or click outside of the entry field to calculate rate-based or weight-based parameters.
Once the calculation results are displayed, you can make changes only to the field you entered originally.
To deliver the total volume at a constant rate in less than 24 hours, type the number of hours in the Total Time field. Cycling rates must span a 24 hour period.
The Infuse Total Volume and Rate are automatically populated with the values from the Calculate section.
To order more or less TPN volume (ml) than calculated, type a new value in the Infuse Total Volume field. The ml/kg/day calculation updates automatically as you type, but the Rate values are unaffected. This changes the amount of TPN to be prepared by Pharmacy.
To increase or decrease the rate of infusion without affecting the amount of TPN to be prepared by Pharmacy, type a new value in the Infuse Rate field. No other values are affected by this.
Click an option to select the administration route: Central or Peripheral.
Type instructions as needed.
Select a start time (9pm on any day within one week).
Click OK (ALT+O).
When prompted, include associated orders as needed. See Consequent Orders for more information.
Orders written for peripheral administration are described as Peripheral Parenteral Nutrition (PPN).
Write additional orders as needed, then sign the session.