Parenteral Nutrition Flashcards
When should PN be used in Crohn’s disease?
Only after failure to tolerate EN
What is an indication for PN support in an adult cancer patient?
Abdominal tumor resulting in an unresolved small bowel obstruction for greater than 7 days.
The routine use of preoperative PN is indicated for patients with a non-functioning GI tract who are:
Severely malnourished
W when is PN indicated in severe burn patients?
Enteral nutrition is contraindicated or unlikely to meet nutrition needs
In the critically I’ll obese patient, specific guidelines for the provision of calories and protein have been recommended by both the Society of Critical Care Medicine and ASPEN. For a patient with a BMI >33.4, which of the following choices best reflects those recommendations for the provision of protein in EN and PN?
Greater than or equal to 2.0 g/kg IBW
A prefab ant patient is admitted with hyperemesis gravidarium (HG). What is a clinical indication for PN use?
Intolerance to EN and supportive care measures.
In the critically ill obese patient, specific guidelines for the provision of calories and protein have been recommended by both the SCCM and ASPEN. For a patient with a BMI of 33.4, what are the calorie recommendations for PN and EN?
11-14 kcal/kg actual body weight
What is an indication for the use of PN?
High output fistula
What PN formula can be safely administered through a peripheral line?
10% dextrose and 3% amino acid
Which central venous catheter is the least favorable for PN infusion?
Femoral catheter
According to the CDC , which of the following is true regarding PICC line care?
Remove the PICC line only if it is suspected or known source of infection.
When is it the most appropriate to start PN infusion in a patient with a new central venous catheter inserted at the bedside without fluoroscopy?
After chest X-ray confirms correct placement of catheter tip.
What is a disadvantage of a PICC line?
Limited self care ability
What is the most appropriate distal catheter tip placement of a peripherally inserted central catheter?
Superior vena cava
Branched chain amino acid (BCAA) formulas would be most appropriate for:
A cirrhotic patient with chronic encephalopathy who is intolerant of standard protein sources despite optimal pharmacotherapy.
In a patient with heptobiliary disease, which trace elements should be withheld or requires a dosage reduction when prescribing PN?
Copper and manganese
Which component is not a major source of aluminum contamination in PN solutions?
Lipid injectable emulsion (ILE)
A long term PN patient begins to experience Parkinson-like symptoms. Which trace element toxicity is most likely to present with these symptoms?
Manganese
When compared to the DRIs for fat soluble vitamins given orally, the DRIs for parenteral my administered fat soluble vitamins are:
Equal
When compared to DRIs for water soluble vitamins given orally, the DRIs for parenteral my administered water soluble vitamins are:
Higher
What best describes a lipid injectable emulsion produced by the transesterfication of fatty acids to form a composite triglyceride molecule?
Structured
The adverse effects of lipid injectable emulsion administration in adults is best prevented by
Avoiding serum triglyceride levels of >400 mg/dL
Failure to provide linoleic and alpha linoleic acids with PN will most likely result in:
Essential fatty acid deficiency
Which parental amino acid (AA) formulation should be used in a hospitalized adult patient with acute kidney injury?
Standard AA formulation
