Chapter 21 - Parenteral Nutrition Support

Question 1

What is parenteral nutrition?

Answer 1

• delivery of nutrient solutions directly into the vein, bypassing GI tract
• deliver macro and micro nutrients into large vein so blood flow is sufficient to dilute solution

Question 2

Important abbreviations

Answer 2

• TPN = total parenteral nutrition
• CPN = central parenteral nutrition
• PPN= peripheral parenteral nutrition

Question 3

Who is a candidate for PN?

Answer 3

• no functioning GI tracts
• could be harmful if they use GI tract
• severe GI bleeding
• High output fistulas
• paralytic ileus
• intractable vomiting or diarrhea
• complete intestinal obstruction
• severe malabsorption
• major bowel resection

Question 4

Vein access

Answer 4

• peripheral: used for short periods of time

- central: used for total PN

Question 5

PPN

Answer 5

-short term: 7-10 days
-not indicated for:
>high energy requirements
>weak peripheral veins
>fluid restrictions

Question 6

TPN or CPN

Answer 6

• uses larger central veins

- volume greater and nutrient concentrations not limited

Question 7

Macronutrients in PN

Answer 7

-AA = 4 kcal/g
-CHO = dextrose = 3.5 kcal/g
-Lipids:
>10% provides 1.1 kcal/g
>20% provides 2.0 kcal/g
>30% provides 3.0 kcal/g

Question 8

Micronutrients in PN

Answer 8

• trace minerals: zinc, copper, chromium, selenium, manganese *iron given in a separate injection
• electrolytes: major minerals > sodium, potassium, chloride, calcium, magnesium, phosphorus
• multivitamin: no vitamin k for patients on Coumadin

Question 9

Transition feeding

Answer 9

TPN»»PO
TPN»>enteral»>PO
TPN + enteral»>PO