TPN

Question 1

TPN is also called

Answer 1

Hyperalimentation

Question 2

Nursing Considerations:

Keep _______; ____ for administration; let ___ out for a few minutes prior to _____.
• Central line needed because ____?
• Filter needed
• Nothing else should go through this line (dedicated line)
• Discontinued gradually to avoid ___________________________
• Daily ___________
• May have to start taking _____________________
• Blood glucose monitoring q6 hours
• Check __________ (for ______________ & ______________)
• Do not mix ahead- mixture changes everyday according to electrolytes.
• Can only be hung for 24 hours.
• Change tubing with each new bag.
• IV bag may be covered with dark bag to prevent chemical breakdown.
• Needs to be on a pump
• Home TPN-emphasize hand washing
• Most frequent complication→ _______________________________

Answer 2

1. )refrigerated; warm for administration; let sit out for a few minutes prior to hanging.
2. )•Central line needed—because this stuff is packed with particles and particles eat up Periphal veins
3. )• Filter needed
4. )• Nothing else should go through this line (dedicated line)
5. )$• Discontinued gradually to avoid _ hypoglycemic
6. )Daily __weights_

7.)May have to start taking _________insulin_
Blood glucose monitoring q6 hours

8. Check urine (for ____ketones_____ & _____glucose___) ­if you have exes glucose in your urine that means you have exess glucose in your blood
9. )Do not mix ahead­ mixture changes everyday according to electrolytes.
10. .)Can only be hung for 24 hours.
11. )Change tubing with each new bag.
12. )IV bag may be covered with dark bag to prevent chemical breakdown.
13. )Needs to be on a pump
14. )Home TPN­emphasize hand washing
15. )Most frequent complication→ ________infection

Question 3

Assisting the MD to insert a central line:

Have saline available for flush; do not start fluids until positive confirmation of placement (CXR).
Position? __________________________to distend veins.
If air gets in the line what position do you put the client in? _______________ __________________

Answer 3

Have saline available for flush; do not start fluids until positive confirmation of placement (CXR).

Position? ____ Trendelenburg__to distend veins.

If air gets in the line what position do you put the client in?
_lungs! Left side Trendelenburg so it would gather in the apex of the right ventricle so it won’t go into the lungs

Question 4

When you are changing the tubing, how can you avoid getting air in the line?

Clamp it off

Valsalva
Take a deep ____________ and HUMMMMMM

Why is an x-ray done post-insertion?
Check for __________________________________

Make sure your client does not have a ________________________.

Answer 4

When you are changing the tubing, how can you avoid getting air in the line?

1.)Clamp it off

2.)Valsalva
Take a deep __ breath_ and HUMMMMMM

3.)Why is an x­ray done post­insertion?
Check for _______________________placement ____

Make sure your client does not have a neuro thorax
We are taking his central line out make sure you make the client lay flat and tell to Valsalva could this will increase the pressure inside the body can prevent them from getting an air embolus and then put it inclusive dressing over the site

Question 5

When an air embolus is suspected in the heart the client may be taken to the ____ lab for removal of the ____

Answer 5

When an air embolus is suspected in the heart the client may be taken to the cath lab for removal of the air

Question 6

Why is a central line needed ?

Answer 6

because this stuff is packed with particles and particles eat up Periphal veins

Question 7

Why do we Discontinued gradually

?

Answer 7

to avoid _________ hypoglycemic

Question 8

You monitor Glucose every ___?

Answer 8

6 hours

Question 9

You check urine for what ?

Answer 9

____ketones_____ & _____glucose___) ­if you have exes glucose in your urine that means you have exess glucose in your blood

Question 10

TPN is hung every ____?

Answer 10

24 hours

Question 11

Change tubing with ___.

Answer 11

with each new bag.

Question 12

IV bag may be covered with__?

Answer 12

dark bag to prevent chemical breakdown

Question 13

TPN needs to be on a ____?

Answer 13

Pump

Question 14

Protein can’t leak through the glomerulus unless ___

Answer 14

There is kidney damage

Question 15

You keep TPN_____ when it’s not being used ,?

What is done to TPN before administration?

What do you do prior to hanging TPN?

Answer 15

1. ) refrigerator
2. ) WARM
3. ) let sit out -this is just mean set it out on the counter for a little bit

Question 16

What else goes through the central line ?

Answer 16

Nothing