Monica - Week 8 - Exam 3 Flashcards
what are three reasons we give parenteral nutrition in acute care setting?
- administration of nutrients other than GI tract
- not able to tolerate enteral feedings
- delivers complete nutritional support
what are 4 considerations when it comes to parenteral nutrition?
- critical illness after 7 days of hospitalization and enteral not feasible
- protein-calorie malnutrition
- major GI surgery and not able to feed (GI resection)
- unable to meet energy requirements after 7 - 10 days by enteral route alone (helps supplement PO nutrient)
what are 8 other indications of parenteral nutrition?
- chronic severe diarrhea and vomiting
- complicated surgery or trauma
- intractable diarrhea (loss of F+E)
- GI tract abnormalities
- severe malabsorption
- GI obstruction
- severe anorexia nervosa
- short bowel syndrome (missing/removed; most nutrients absorbed here)
what is the osmolarity of PPN?
osmolarity NTE 900 mOsm/L
what is one indication for PPN?
supplement inadequate oral intake
how long can someone be on PPN?
temporarily; nutritional support for < 2 weeks
when is PPN administered?
administered around the clock or in cycles
how many calories does PPN offer?
provides < 2000kcal/day
what is the volume (size) of a PPN bag?
2000 - 3000 mL
what is the osmolarity of TPN?
ranges from 1500 - 2800 mOsm/L
what is one indication for TPN?
to correct nutritional deficits
who is a candidate for TPN?
a patient that has high protein/calorie requirements
how long can some be on TPN?
> 2 weeks
how many calories does TPN offer?
> 2000 kcal/day
how much dextrose might TPN contain?
may contain up to 50% dextrose
**may think about adding insulin??
what is the volume (size) of a TPN bag?
1 - 2 L bags; infusion volumes < PPN d/t higher tonicity
there is a risk for _______ when using both TPN and PPN.
phlebitis; 3-4 days –> start new IV to ensure patency and decrease risk of phlebitis
how is TPN given??
ONLY THROUGH A CENTRAL LINE; WE CAN’T GIVE THIS YET
what are 5 assessments/lab tests we need to be aware of when giving PN?
- height/weight, ideal body weight, % of weight loss
- electrolytes (Na+, K+, Mag+, glucose, Ca2+)
- protein level (6 - 8g/dL; protein deficit?)
- kidney function (BUN, Cr, GFR)
- liver enzymes
why are we assessing function of the kidneys and liver?
to see if liver and kidneys can handle the PN (metabolism and excretion); can’t give too much protein if kidney/liver problems
what is the normal range for pre-albumin?
17 - 40mg/dL
what does pre-albumin tell us?
- protein synthesis (mainly made by liver)
- assess malnutrition risk (can tell us RIGHT NOW if there is malnutrition)
what is the half life of pre-albumin?
2 days - that’s why it’s a good indicator of current state of malnutrition
T/F pre-albumin is more sensitive to changes in protein status
TRUE - d/t half life of 2 days
