Chapter 10- Total Parental Nutrition Flashcards
parenteral nutrition
used when client’s gastrointestinal tract is NOT functioning, or when client cannot physically or psychologically consume sufficient nutrients orally or enterally (Ex: cancer, patient with critical illness, trauma, burns)
- providing nutrition to blood stream through veins
components of parenteral nutrition solution
- carbohydrates or dextrose
- Electrolytes, vitamins, and trace elements
- lipids
- proteins
higher concentration of dextrose is prescribed…
for pt on fluid restriction
lower concentration of dextrose is prescribed…
used to help control hyperglycemia
lipids
used to correct or prevent essential fatty acid deficiency
-milky appearance
how is lipid form?
combination of soybean oil, and/or safflower oil, and egg phospholipids
IV lipids are contraindicated to what?
clients who have HYPERlipidemia, severe hepatic disease or an allergy to soybean oil eggs or safflower oil
what solution is lipid in?
10%, 20%, and 30%
what does lipid do?
Provides calories WITHOUT increasing PN osmolarity
protein
provided as mixture of essential and nonessential amino acids
what concentration is protein in?
3.5%-15%
what determines the amount of proteins needed?
liver and kidney function
which 2 medications can be added to PN solution?
insulin and heparin
- need a separate line for medications (do not use same line as TPN)
what is contraindicated for IV meds?
administering it through PN IV line or port
TPN used for…
For longer term therapy >7 days
- need intense nutritional support
- can contain up to 70% dextrose
where is TPN administered?
through central vein
PPN used for…
when pt unable to consume enough calories
where is PPN administered?
through peripheral vein
how should PPN solution be?
Solution must be isotonic, cannot contain more than 10% dextrose
what is required on IV tubing?
micron filter and IV infusion pump
how do you avoid hypoglycemia?
an IV of dextrose 10%-20% in water is administered if the PN solution is unavailable
when should you change bag and tubing?
every 24 hours
when should PN be discontinued?
Pn should be discontinued when client’s enteral or oral intake can provide 60% or more of calorie requirements
-Discontinuation should be done GRADUALLY to avoid rebound Hypoglycemia!
