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nurs 321 > TPN > Flashcards

TPN Flashcards

1
Q

parenteral nutrition

A

nutrients administered intravenously and can be given in conjunction with enteral feeding to meet body requirements

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2
Q

most common
- dextrose

A

carbs

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3
Q

dextrose

A

part of carbs
- easily metabolized, stimulates insulin secretion, helps to create proteins

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4
Q

fat emulsion; fatty acids; soy bean and egg yolk; isotonic
- concentrated source of calories
- available in 10, 20, 30 %
- is a good medium for bacterial growth which can cause infection

A

lipids

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5
Q

proteins
- concentrations range from 5-15 %
- meds can be added but only by pharmacy

A

amino acids

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6
Q
  1. meet caloric needs until patient can be transitioned to enteral nutrition (maintain body ability to fight infection)
  2. transition to enteral to prevent cell shrinkage
  3. preventing complications like septicemia
A

goal of PN

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7
Q
  1. patients unable to digest or absorb enteral nutrition (non functional GI and extended bowel rest)
  2. highly stressed psychological states (sepsis, head injury, burns)
  3. perioperative TPN (bowel rest)
A

indications for PN

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8
Q

Marasmus

A

starvation

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9
Q

kwashiorkor

A

extended bowel but still starvation

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10
Q

effects of malnutrition

A

decreased wound healing, muscle mass
increased risk of fall, infection

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11
Q

BMI less than 18.5

A

underweight

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12
Q

BMI 18.5-24.9

A

desirable

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13
Q

BMI 25-29

A

overweight

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14
Q

Albumin

A

protein synthesized by liver; prevents fluid from leaking into interstitial spaces
- found in plasma

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15
Q

Transferrin

A

transports iron in plasma and synthesized in liver

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16
Q

prealbumin

A

required for thyroxine transport

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17
Q

nitrogen balance

A

indicator of gain or loss of protein

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18
Q

hair assessment findings

A

dull, thin, dry

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19
Q

nail assesment findings

A

thin and concave

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20
Q

heart assessment findings

A

tachycardic, enlarged

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21
Q

abdomen assessment findings

A

hepatomegaly

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22
Q

muscle and extremity findings

A

muscle wasting, edema, pain

23
Q

surgery, paralytic ileus, obstruction, head trauma, chemo/radiation therapy

A

non functional GI tract indications

24
Q

IBD, enterocutaneous fistula, pancreatitis

A

extended bowel rest indications

25
Q

zinc

A

important for wound healing

26
Q

copper

A

works with iron to form RBC

27
Q

chromium

A

potentiates insulin reactions

28
Q

PPN

A

see more in bowel rest pre surgery
- short term
- peripheral
- less than 10% dextrose

29
Q

TPN

A

through central line
- can be greater than 10% dextrose

30
Q

40cc-60cc

A

amino acid dextrose infusion pump rate

31
Q

10cc-20cc

A

lipid emulsion infusion pump rate

32
Q

pneumothorax

A

mechanical complication due to catheter insertion

33
Q

S&S of pneumothorax

A

sudden sharp chest pain, SOB, coughing

34
Q

causes of air embolus

A

mechanical complication
- catheter insertion
- cap/tubing change
- sudden dislodgement

35
Q

S&S of air embolus

A

tachypnea, wheezing, hypotension, cyanosis, ST depression

36
Q

hyperglycemia

A

metabolic complication relating to solution used

37
Q

hypercapnia

A

metabolic complication; buildup of CO2 in bloodstream
- due to excessive rates of carbohydrate infusion

38
Q

S&S of hypercapnia

A
  • will present with increased CO2 (above 45)
  • SOB
  • anxiety
39
Q
  • typically supplied as 20%
  • stored at room temp
  • stable for 12 hours once primed
  • indicator on back must be yellow, no other colour
A

lipid solution

40
Q

mix of protein and carbs
- individualized
- take out of fridge 30 min before
- good for 24 hours once spiked
- use in order #
- give through central line

A

Travasol

41
Q

lipid filter

A

1.22 micron filter

42
Q

amino acid filter

A

0.22 micron filter

43
Q

Olimel (3 in 1) infusion time, fatty acid base, and filter

A

infusion time max 24hr from priming
- fatty acid olive oil based instead of soy
- high protein and less glucose
- requires 1.22 micron filter

44
Q

cyclin PN

A

administering PN over reduced time frame for patients on long term PN
- over 8 to 16 hours instead of continuous 24 hours

45
Q

renal failure formula

A

composed mainly of amino acids

46
Q

In TPN hypomagnesemia is caused by…

A

caused by refeeding syndrome

47
Q

S&S of hyperglycemia

A

fruity breath, anxiety, confusion, thirsty, tired, lethargy

48
Q

S&S of hyperkalemia

A

cardiac arrest, muscular weakness, diarrhea, tall T wave
- give insulin

49
Q

S&S of hypocalcemia

A

irritability, confusion, muscle cramps, seizures

50
Q

S&S of hypokalemia

A

constipation, hypotension, bradycardia

51
Q

S&S of hypomagnesemia

A

muscular hyperexcitability, tremors, tachycardia, V-fib

52
Q

S&S of hypophosphatemia

A

decreased RBC, insulin resistance

53
Q

S&S of refeeding syndrome

A

dyspnea, tachycardia,

54
Q

solution to use if patient is disconnected from PN/TPN

A

D10 W

nurs 321 (7 decks)

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