ASPEN ch 14--PN overview Flashcards
why crystalline a.a. better?
better utilized and lack preformed ammonia
3-in-1 also called ____ admixture
total nutrient
PN is hypertonic to body fluids and can result in _______ if admin inappropriately
venous thrombosis, suppurative thrombophlebitis, extravasation
osmolarity of PN formula primarily depend on these components:
dextrose (5mOsm/g), a.a. (10mOsm/g), electrolytes (1mOsm/g)
max osmolarity of PPN:
900mOsm
CPN often referred to as:
total parenteral nutr
why can handle greater osmolarity in CPN?
rate of blood flow in large vessels rapidly dilutes hypertonic formulation to that of body fluids, minimize risk of complications
PPN used up to ____ days
14
why PPN undesirable for pt on fluid restriction?
large fluid vols needed because can’t concentrate solution too much
why limit PPN?
tolerance limit, few suitable veins
for PPN must meet these 2 criteria:
good peripheral venous access and able tolerate large volumes of fluid
__ may be used to ^ energy density of PPN without increasing osmolarity, can improve vein tolerance of PPN:
ILE
use of ___ catheters recommended in pt needing PPN>6 days
midline (lower probability dislodge)
contraindications to PPN:
significant malnutrition, severe stress, large nutr/electrolyte needs, fluid restriction, prolonged PN need, renal/liver probs
____ concept is relevant to critically ill pt who don’t tolerate nutr (esp PN) well
permissive underfeeding
