Parentral Nutrition Flashcards
True or false.
Parenteral nutrition solutions are hypotonic?
False.
TPN solutions are hypertonic
-highly concentrated in comparison to the solute concentration of blood
Who might need parenteral nutrition?
Severe malnutrition NPO patients for extended periods of time -major surgeries Severe burns Bowel disease disorders Cancer Extended bowel rest Sepsis AIDS
Risks of TPN?
Infection
-surgical aseptic technique
Electrolyte, fluid and glucose imbalances
-frequent evaluation and modification of TPN mixture
Peripheral parenteral nutrition vs total parenteral nutrition?
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
Why nutritional support?
D5W, NS and LR do not supply enough nutritional support
Problems with malnutrition?
Poor wound healing
Increased risk for infection
60-70 days without food causes death
Goals of parenteral nutrition?
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
What is malnutrition?
Change to body composition and diminished function related to combination of over nutrition or under nutrition with or without inflammatory activity
Complications of malnutrition?
Longer hospital stays
More infectious and non infectious complications
Greater risk of mortality
What is marasmus?
Severe undernourishment characterized by energy deficiency
- loss of muscle and subcu fat
- head appears large
- protein but no calories
What is kwashiorkor?
A form of malnutrition caused by protein deficiency diet
- calories but not enough protein
- edema
Who uses peripheral parenteral nutrition?
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
Members of health care team involved in TPN?
Dietician Pharmacist Nurses Family MRP
Components of TPN?
Carbohydrates Fats Proteins Electrolytes Vitamins Trace elements
Additive products based on individual patient needs
Ex. Insulin, minerals
Advantages of TPN?
Patient is nutritionally balanced
Improves tolerance to surgery
Allows for bowel rest and healing
Beneficial for longterm use
Disadvantages of TPN?
Minor surgical procedure
May cause metabolic complications
Risk of:
-pneumothorax, air embolism, vein thrombosis, catheter malposition, nerve injury, infection
Nursing assessment of pts on TPN?
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
What is parental nutrition?
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
What is refeeding syndrome?
A metabolic complication that occurs when nutritional support is given to severely malnourished pts
Anabolism?
The synthesis of complex molecules in living organisms from simpler ones with the storage of energy
Catabolism?
The breakdown of complex molecules in living organisms to form simpler ones together with the release of energy
What is cachexia?
Weakness and wasting of the body d/t severe chronic illness
