Exam 1: Parenteral Nutrition Flashcards
Parenteral Nutrition (PN)
A method of providing nutrients to the body by an IV route
Preferred site for PN?
Superior Vena Cava
Indications for PN include
inability to ingest adequate oral foods or fluids within a 7-10 day time frame
How much formula is given?
1 - 3 L over a 24 hour period
Intravenous fat Emulsions (IVFEs or Lipids) may be…
infused simultaneously with PN through a Y connector close to the infusion site and should not be filtered
How much IVFE is normally given?
500 ml of 10% or 250 mL of 30% over 6-12 hours
IVFE can provide how much of daily caloric intake?
30%
What is a TNA?
A total nutrient admixture, where IVFEs and other mixtures can be added to the PN
What are the Standing Orders for PN?
Weighing the patient, monitoring I/O, Blood Glucose, And periodic monitoring of blood count, platelet count, and chemistry panel including serum CO2, Mg, P, and Triglycerides
How can PN be given?
Through Peripheral or Central IV Lines
What is PPN?
Peripheral Parenteral Nutrition, and is given through a peripheral vein. Given to supplement oral intake. This is possible because the solution is less hypertonic than a full-calorie PN solution. Have low dextrose content
Length of PPN?
5-7 Days
What is CPN?
Central Parenteral Nutrition, and solutions have 5-6 times the solute concentration of blood. Isotonic levels in the blood cause this to be very rapidly diluted.
What types of Central Venous Access Devices are there?
Percutaneous (Nontunneled)
Peripherally Inserted Centeral Catheters (PICCS)
Surgically Placed Catheters
Implanted Vascular Access Ports
Percutaneous Centeral Catheter duration
Used for short time (less than 6 weeks)
Vein for Percutaneous Centeral Catheter?
Subclavian vein because this provides a stable insertion site to which the catheter can be anchored.
Percutaneous Centeral Catheter: When shoudl the subclavian access site be avoided?
Avoided in patients with advanced kidney disease and those on hemodialysis to prevent subclavian vein stenosis.
Percutaneous Centeral Catheter: Second most common site?
Basilic, brachial, or cephalic veins in the arms followed by jugular vein.
Femoral vein should be used as last resort.
What would be used for a patient with limited IV access?
Triple-Lumen Catheter, because it offers three ports for various uses.
Duration for PICCS?
Used for intermediate term , days to months) , IV therapy in the hospital, long-term care or home setting
Who can insert a PICCs?
Primary provider bedisde or even by a specially trained nurse
Where does a PICC go?
The basilic, brachial, orcaphalic vein is accessed above the antecubital space, adn catheter is threaded to the superior vena cava.
What should you not do with a PICC
Taking blood pressure and blood specimens form the extremity with the PICC is avoided
Surgically Placed CentralCatheters Duration
May remain in place for many years
