The pharmacy department received the following parenteral nutrition orders for a 79-year-old patient.

Nutrition Goal:
- 1750 total calories per day from all sources

Parenteral Solution:
- Dextrose 312 grams
- Amino acids 62 grams
- Sodium chloride 32 mEq
- Sodium acetate 12 mEq
- Potassium 20 mEq
- Magnesium sulfate 10 mEq
- Phosphate 28 mmol
- Calcium 24.5 mEq
- Multivitamins 10 mL
- Trace elements 1 mL
- Famotidine 10 mg
- Regular insulin 10 units
- Sterile water qs ad 1900 mL

The pharmacy technician compounding the PN solution used potassium phosphate to add the 28 mmol of phosphate needed. If potassium phosphate solution contains 3 mmol of phosphate and 4.4 mEq of potassium in each mL, how many extra mEq of potassium have been added beyond what was prescribed?

To calculate the extra mEq of potassium that have been added beyond what was prescribed, first calculate the total amount of potassium phosphate that was added to the solution. We know that each mL of potassium phosphate solution contains 3 mmol of phosphate and 4.4 mEq of potassium. Since the order is for 28 mmol of phosphate, add 28/3 = 9 mL of potassium phosphate solution.

The total amount of potassium in the 9 mL of potassium phosphate solution is 9 x 4.4 = 39.6 mEq.

The order is for 20 mEq of potassium, so 39.6 - 20 = 19.6 mEq of potassium have been added beyond what was prescribed.

So the answer is 19.6

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