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PA30304 > Parenteral nutrition > Flashcards

Parenteral nutrition Flashcards

1
Q

Who needs PN?

A 
Pre-term infants
Bowel obstruction
Short bowel
Crohn's disease
Multiple trauma
Pseudo-obstruction
Short term gut rest
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2
Q

What is the primary goal of PN?

A

Provide adequate calories and proteins whilst maintaining fluid balance
Prevent malnutrition and associated complications

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3
Q

What will PN contain?

A 
Proteins 
Carbohydrate 
Fat 
Electrolytes
Trace elements
Vitamins A,B,C,D,E
Water
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4
Q

What is in a triple chamber PN bag?

A

separate glucose, amino acid and lipid

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5
Q

What is in a 2 in 1 PN bag?

A

Aqueous ingredients only (separate lipid to aid stability)

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6
Q

What is in a 3 in 1 PN bag?

A

All ingredients in one bag (aqueous & lipid)

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7
Q

What is in a lipid PN bag?

A

Fat/lipid based ingredients (separate from aqueous)

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8
Q

What is in a 1 in 1 PN bag?

A

Amino acid and electrolyte replacement

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9
Q

Stability and compatibility of PN formulations are influenced by what?

A

Ingredients
Preparation and compounding
Containers
Storage

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10
Q

What can happen if PN bags are exposed to sunlight?

A

Breakdown of Vitamin A

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11
Q

When does precipitation occur?

A

When chemicals interact to form insoluble salts

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12
Q

When can precipitation occur?

A

When adding strong injections of calcium/magnesium/phosphate to PN without mixing between additions

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13
Q

What pH should PN bags be maintained at?

A

5.0 or above (below 6.0 to reduce precipitation)

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14
Q

What should be added to amino acids in PN?

A

macro-electrolytes

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15
Q

What should be done to calcium and phosphate components before mixing in PN bag?

A

Separate and dilute

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16
Q

What should be mixed before adding lipid?

A

amino acids and glucose

17
Q

What should be added last to a PN bag?

A

Fat

18
Q

What should be added to lipid in PN bag?

A

Vitamins

19
Q

What should trace elements be added to in PN bags?

A

Glucose

20
Q

Should vitamins and trace elements be separated or mixed in PN bags?

A

Separated

21
Q

Is fat provided as an oil in water or water in oil suspension?

A

oil in water

22
Q

What factors affect the lipid emulsion stability?

A 
Positive ions
pH
Glucose conc
Time
Lipid emulsion dilution
23
Q

Amino acids chelate with what?

A

cations

24
Q

What container type is best for PN bags?

A

Multilayer

25
Q

Why is PVC not ideal for PN bags?

A

Leaching of plasticisers

26
Q

Why is EVA not ideal for PN bags?

A

Poor oxygen barrier

27
Q

Where should PN feeds be stored?

A

refrigerator

28
Q

How long should PN feeds be allowed to warm up for before use?

A

1 hour

PA30304 (13 decks)

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