Total Parenteral Nutrition Flashcards
How are nutrients administered through TPN? Can all nutrients be met?
Amino acids, free fatty acids, and monosaccharide (dextrose)
Solution can be customized to meet all needs!
What is TPN?
all nutrients put right into bloodstream through a vein.
It does not use the GI tract at all. (Parenteral=outside)
When would you choose TPN over TF?
Non-functioning GI tract Haven't eaten for over 5 days Anorexia Cancer AIDS
When are 2 times to NOTuse TPN?
GI tract is working
The prognosis (die in 2 days) does not match need for NS.
When should someone be moved from TF to TPN?
If not meeting at least 60-65% of needs from TF then needs to be switched to TPN
Characteristics of PPN. What is it?
Nutrients in vein of arm
Doesn’t meet kcal goals
Lipid based to keep
Characteristics of CPN. What is it?
Meets all nutrients and fluid goals (Kcal, micro, protein, fluid) can be >900 mOsm Used for long term > 7 days Used with FR Good for access to other port
What are the 2 types of CPN?
Tunneled catheter- tip in superior vena cava
PICC (peripherally inserted central catheter)- into arm vein then catheter goes into superior vena cava.
What are the perks of PICC?
Increased mobility and decreased risk of infection.
Formula to calculate consumed Nitrogen.
Grams of pro * 1g N/ 6.25g Pro
“You have to eat a lot of protein to get 1 g N”
Protein in TPN
Usually 3.5-20% AA (3.5-5.5 PPN)
4kcal/kg
15-20% total kcal from protein
What is NPC:N?
Non-protein Calories: Nitrogen Ratio
Prioritized the amount of protein needed to match someone’s stress status.
Dextrose in TPN.
Usually 5-70%
3.4 kcal/g
There are max rates of tolerance and infusion b/c blood can only handle so much dextrose at once.
Lipids in TPN.
Intralipid 10% kcal/mL
Intralipid 20% kcal/mL
- 1 kcal/mL
2. 0 kcal/ mL
