Parentral Nutrition Flashcards

1
Q

True or false.

Parenteral nutrition solutions are hypotonic?

A

False.
TPN solutions are hypertonic
-highly concentrated in comparison to the solute concentration of blood

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2
Q

Who might need parenteral nutrition?

A
Severe malnutrition
NPO patients for extended periods of time 
-major surgeries 
Severe burns 
Bowel disease disorders
Cancer 
Extended bowel rest 
Sepsis 
AIDS
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3
Q

Risks of TPN?

A

Infection
-surgical aseptic technique

Electrolyte, fluid and glucose imbalances
-frequent evaluation and modification of TPN mixture

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4
Q

Peripheral parenteral nutrition vs total parenteral nutrition?

A

PPN:

  • delivered into smaller veins
  • cannot handle as concentrated solutions
  • safe and convenient
  • frequent incidence of phlebitis
  • short periods
  • must be isotonic solutions

TPN:

  • Injected into high-flow central veins
  • not risk free (infection, imbalances)
  • greater concentrations and fluid volumes than PPN
  • prolonged periods of time
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5
Q

Why nutritional support?

A

D5W, NS and LR do not supply enough nutritional support

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6
Q

Problems with malnutrition?

A

Poor wound healing
Increased risk for infection

60-70 days without food causes death

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7
Q

Goals of parenteral nutrition?

A

Provide all necessary nutrients to sustain nutritional balance
Preserve or restore body’s protein metabolism and prevent malnutrition
Diminish rate of weight loss and maintain or increase body weight
Promote wound healing
Replace nutritional deficits

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8
Q

What is malnutrition?

A

Change to body composition and diminished function related to combination of over nutrition or under nutrition with or without inflammatory activity

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9
Q

Complications of malnutrition?

A

Longer hospital stays
More infectious and non infectious complications
Greater risk of mortality

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10
Q

What is marasmus?

A

Severe undernourishment characterized by energy deficiency

  • loss of muscle and subcu fat
  • head appears large
  • protein but no calories
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11
Q

What is kwashiorkor?

A

A form of malnutrition caused by protein deficiency diet

  • calories but not enough protein
  • edema
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12
Q

Who uses peripheral parenteral nutrition?

A

Used for patients who are already or have potential for developing malnutrition and who are not candidates for enteral nutrition

These patients need:

  • good peripheral IV access
  • be able to tolerate large volumes of fluid
  • limited to 10% or less to prevent vein irritation, damage to vein and clots
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13
Q

Members of health care team involved in TPN?

A
Dietician
Pharmacist 
Nurses 
Family 
MRP
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14
Q

Components of TPN?

A
Carbohydrates 
Fats
Proteins
Electrolytes 
Vitamins 
Trace elements

Additive products based on individual patient needs
Ex. Insulin, minerals

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15
Q

Advantages of TPN?

A

Patient is nutritionally balanced
Improves tolerance to surgery
Allows for bowel rest and healing
Beneficial for longterm use

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16
Q

Disadvantages of TPN?

A

Minor surgical procedure
May cause metabolic complications
Risk of:
-pneumothorax, air embolism, vein thrombosis, catheter malposition, nerve injury, infection

17
Q

Nursing assessment of pts on TPN?

A
Verifying correct placement 
Monitor VS
Monitor blood glucose
Daily weights
I&O
Monitor for signs of infection
Physicians orders
Assessing solution
Tubing and solution changes
18
Q

What is parental nutrition?

A

IV infusion of water, protein, carbohydrates, electrolytes, minerals and vitamins through a central vein into superior vena cava

Provided when the GI tract is nonfunctional, absorption is impaired or patient must remain NPO for extended periods of time

19
Q

What is refeeding syndrome?

A

A metabolic complication that occurs when nutritional support is given to severely malnourished pts

20
Q

Anabolism?

A

The synthesis of complex molecules in living organisms from simpler ones with the storage of energy

21
Q

Catabolism?

A

The breakdown of complex molecules in living organisms to form simpler ones together with the release of energy

22
Q

What is cachexia?

A

Weakness and wasting of the body d/t severe chronic illness