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The ICU Book by Marino <\/p>\n
ICU Book notes tubular epithelial cells and epithelial cell casts is pathognomic for ATN if patient is hypokalemic, get urine lytes and urine potassium if urine potassium <30 mEq\/L most likely diarrhea if >30 check U Cl <15=NG drainage or alkalosis >25=diuretics of Mg depletion mg depletion incredibly underdx in icu get art on hypocalcemia in the critically ill (Crit Care Med 1992;20:251) check an occ. phosphate gi sources of sepsis acid suppression leads to gi contamination in upper track source antibiotics cause lower track contamination + urine culture=>10 5th power cfu\/cc gram positive organisms in urine in icu-think enterococcus give cipro or vanco+genta TPN Cal = 25 kcal\/kg\/day Protein=1.4 g\/kg\/day Take 500 cc 10% Amino Acid Mix and D50 500cc A10-D10 Final concentration is 50G prtotein per liter and 250 G dextrose per liter Volume L per day= Protein gms\/50 g\/L take the volume amount and multiply by 250 Grams of dextrose=gms\/day dextrose g\/day x 3.4 kcal\/g=Kcal\/day given by the A10-D10 Give remainder of calories by lipids lipids =1 kcal\/cc come in 50cc dose\/units Haldol give 2-10 mg, double dose every 15-20 minutes then give 1\/4 of total every q6 hours<\/p>\n
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