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Nurse 202 > TPN Complications Week 7 > Flashcards

TPN Complications Week 7 Flashcards

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1
Q

What are some of the 10 major complications associated with TPN administration?

A
  • Sepsis
  • Electrolyte imbalance
  • Hyperglycemia
  • Hypoglycemia
  • Hypervolemia
  • Hyperosmolar Diuresis
  • Hepatic Dysfunction
  • Hypercapnea
  • Lipid intolerance
  • Lipid Particulate Aggregation
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2
Q

What is the cause of TPN associated sepsis?

A
  • High Glucose content in fluid

- VAD contamination

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3
Q

What are the three main nursing assessments/interventions for TPN associated Spesis?

A
  • Monitor Temp
  • Monitor WBCs
  • INspect Insertion site for signs of infection
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4
Q

What are some causes of electrolyte imbalance associated with TPN?

A
  • Introgenic effects of underlying disease (Vomiting, diarrhea)
  • Refeeding syndrome
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5
Q

What are the 4 main nursing assessments/interventions/considerations for TPN associated electrolyte imbalance?

A
  • Monitor Electrolytes daily initially then every 2-3 days
  • Monitor for signs of imbalance
  • Treat underlying cause
  • Change concentration of electrolytes in TPN
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6
Q

What are some causes of Hyperglycemia associated with TPN?

A
  • TPN has a high glucose content

- Patient may have insufficient insulin secretion

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7
Q

What are the 3 main nursing assessments/interventions/considerations for TPN associated hypoglycemia?

A
  • Monitor blood glucose
  • Decrease glucose concentration in TPN
  • Increase insulin
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8
Q

What are some causes of TPN associated hypoglycemia?

A

-An abrupt discontinuation of TPN administered through a central line

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9
Q

What is the main intervention for TPN associated hypoglycemia?

A

Start D10W after discontinuation of centrally administered TPN

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10
Q

What are some causes of TPN associated hypervolemia?

A
  • Intragenic

- Underlying disease (CHF, Renal failure)

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11
Q

What are the 6 main nursing assessments/interventions/considerations for TPN associated hypervolemia?

A
  • Monitor I&O
  • Daily Weights
  • CVP
  • Breath sounds
  • Observe for Peripheral Edema
  • Increase concentration of TPN
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12
Q

What is the cause of TPN associated Hyperosmolar Diuresis?

A

-High Osmolarity of TPN

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13
Q

What are the 4 main nursing assessments/interventions/considerations for TPN associated hyperosmolar Diuresis?

A
  • Monitor I&O
  • Daily weight
  • CVP
  • Decrease concentration of TPN fluid
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14
Q

What is the main cause of TPN associated Hepatic Dysfunction?

A

The high concentration of carbohydrates and/or fats relative to protein in TPN

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15
Q

What are the 3 main nursing assessments/interventions/considerations for TPN associated Hepatic Dysfunction?

A
  • Monitor Liver function tests and tryglyceride levels
  • Check for presence of jaunduce
  • Change formula content
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16
Q

What are some causes of TPN associated Hypercapnea?

A

-The high carbohydrate content of TPN fluid

17
Q

What is the main nursing assessments/interventions/considerations for TPN associated hypercapnea?

A

-Change formula to increase the proportion of fat relative to carbs

18
Q

What are some causes of TPN associated lipid intolerance?

A
  • History of low weight or premature infant
  • History of liver disease
  • History of elevated triglycerides
19
Q

What are the 6 main nursing assessments/interventions/considerations for TPN associated lipid intolerance?

A
  • Monitor for fat overload syndrome
  • Monitor for bleeding
  • Monitor O2 for impaired oxygenation
  • Check Triglycerides levels, liver function, hepatosplenomegaly, discreased coagulation, cyanosis, dyspnea
  • monitor for allergic reactions: Nausea, vomiting, headache, chest pain, back pain, fever
  • Admin lipid solutions slowly, initally, while observing for symptons
20
Q

What is the cause of TPN associated Lipid particulate aggregation?

A

an unstable mixture of dextrose solution with lipid emulsion

21
Q

What is the main nursing assessments/interventions/considerations for TPN associated lipid particulate aggregation?

A

observe for cracking or creaming of fluid and avoid use of fluid with these characteristics

22
Q

Explain the steps of refeeding syndrome

A
  • Malnutrition
  • Protein & Fat Catabolism begin
  • Electrolytes begin to decrease
  • PN or Eating Begins and increases insulin production
  • Electrolytes begin to shift into cells at a rapid rate
  • The rapid shift leads to seizures, HF, and possible Death

Nurse 202 (2 decks)

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