Week 1 - TPN Flashcards
Your client is showing signs of weight gain, peripheral edema, crackles in lungs and I&O imbalance. What condition might these symptoms indicate?
Fluid retention
How often should the tubing be changed for a patient receiving TPN with lipids through a peripheral IV?
Every 24 hours
What should be included in the daily routine of monitoring of a patient on TPN?
- check VS every 4 hours
- check weight daily initially and then at least 3 times a week
- Check electrolytes daily and glucose every 6 hours for 48 hours until within normal limits and stable
What are the most common complications related to TPN (and CVAD)?
Pneumothorax, Air embolism, Infection
T/F. Watch for Hypoglycemia if TPN is discontinued abruptly.
True
Which of the following are indications for parenteral nutrition?
- GI bleed
- Paralytic ileus
- Severe malabsorption
- Severe diarrhea
ALL
TPN can be administered through a peripheral IV as long as the solution is appropriate. Which solution is appropriate for peripheral TPN?
Solutions containing 10% dextrose or less and are less calorically dense
Blood glucose levels are very important to maintain in patients on TPN. Which of the following is true?
- High glucose levels are associated with increased infection rates
- Low glucose levels are common in patients on TPN and lead to frequent events of hypoglycemia
- TPN always provides the exact amount of dextrose so blood sugars levels are easy to maintain for patients on TPN
- Insulin is always given to patients on TPN to control blood sugar spikes
1
T/F. Re-feeding syndrome can occur in very malnourished patients, in which some electrolytes shift into cells with the glucose provided in the TPN solution, resulting in low serum levels that puts the patient at risk for arrhythmia’s and muscle weakness
True
What are some of the symptoms indicate that the patient maybe developing an infection while receiving TPN?
Fever; malaise; chills
What is TPN?
Components: amino acids, glucose, lipids as energy sources with addition of electrolytes, minerals, trace elements, vitamins, water.
Lipid emulsion added = 3 in 1 or TNA.
Who needs TPN?
- nonfunctional GI tract r/t surgery
- chemo
- severe malabsorption
- severe catabolic pmts when GI tract is nonfunctional for >7 days
- maternity -> hyperemesis
Where does TPN administration occur?
acute care or home
How is TPN administered?
- Via PIV or CV AD
List some of the pre-assessments done before administering TPN.
- indication of TPN; lab work; weights; nutritional assessment; glucose levels; allergies; IV site; electrolytes; hydration; lung assessment; urine output I&O
