Specific patient electrolyte requirements can be determined and added, as feasible, to PN solutions. Usually, maintenance doses of electrolytes are determined and provided in daily amounts of electrolytes added to the PN solution. Additional repletion and replacement of losses can occur in electrolyte doses given outside the PN admixture. Sodium and potassium can be added as chloride or acetate, depending on acid-base needs. Physicochemical incompatibilities exist for large quantities of electrolytes added to the same PN formulation. In particular, calcium and phosphorus concentrations must be carefully scrutinized to prevent precipitation. Many factors may influence the solubility of these electrolytes in the PN solution, including the concentration of electrolytes, the pH of the final formula, temperature, and the presence of other components. A nutrition support pharmacist can be a resource to address compatibility concerns.
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