Parenteral Nutrition

Question 1

What are indications for parenteral nutrition?

Answer 1

1. nonfunctioning GI tract
2. inability to tolerate oral/ enteral feeding
3. at risk for nutrition related comorbidities
4. medical condition warrants aggressive nutritional support

Question 2

What are CIs for TPN?

Answer 2

1. functioning GI tract
2. treatment <5 days without severe malnutrition
3. prognosis that does not warrant aggressive nutritional support

Question 3

What medications contain lipids and must be taken into consideration when calculating calories from lipids?

Answer 3

1. Propofol
2. Clevidipine

Question 4

Why is acetate used in TPN instead of bicarbonate?

Answer 4

1. risk of precipitation
2. acetatae readily converted to bicarbonate

Question 5

What is the order of TPN preparation?

Answer 5

1. add electrolytes (except Ca) to dextrose
2. add Ca to amino acids
3. add amino acids to fat (if 3:1) followed by dextrose
4. QS with sterile water

Question 6

What is needed to provide the majority of calories for a PPN?

Answer 6

lipids

Question 7

When should cyclic infusion of TPN be used?

Answer 7

chronic TPN > 7-10 days