Total Parenteral Nutrition

Question 1

Used when a client’s GI tract is not functioning, or when a client cannot physically or psychologically consume sufficient nutrients orally or enterally

Answer 1

Parenteral nutrition

Question 2

Provides a nutritionally complete solution and can be used when caloric needs are very high (>2,500 cal/day), when the anticipated duration of therapy is >7 days, or when the solution to be administered is hypertonic (composed of >10% dextrose).

Answer 2

Total parenteral nutrition

Question 3

How can TPN only be administered?

Answer 3

Central vein

Question 4

Can provide a nutritionally complete solution, however, it is administered into a peripheral vein resulting in a limited nutritional value. It is indicated for clients who require short term nutritional support between 2000-2500 cal/day. The solution must be isotonic and contain no more than 10% dextrose and 5% amino acids.

Answer 4

Peripheral parenteral nutrition

Question 5

IV lipids are contraindicated for who?

Answer 5

Clients who have hyperlipidemia or severe hepatic disease

Question 6

Who should add medications to parenteral nutrition?

Answer 6

Pharmacist - to avoid incompatibilities

Question 7

What may be added to reduce hyperglycemia?

Answer 7

Insulin

Question 8

What may be added to prevent fibrin buildup on the catheter tip?

Answer 8

Heparin

Question 9

TPN is commonly used in:

Answer 9

Clients undergoing cancer treatment, suffering from trauma or extensive burns

Question 10

PPN is used when:

Answer 10

Central venous access is not available, or for transition from TPN to enteral or oral intake. Also when PN is needed for less than 7 days, or when caloric needs are less than 2,500 cal/day

Question 11

What is some evidence supporting the effectiveness of parenteral nutrition?

Answer 11

Daily weight gain of up to 1 kg/day

Increases in albumin levels and in prealbumin levels

Question 12

Occurs if the calcium or phosphorus content is high or if poor-salt albumin is added; has an oil appearance or a layer of fat on top of the solution and should not be used

Answer 12

“cracked” TPN solution

Question 13

The high dextrose content of PN contributes to what?

Answer 13

Bacterial growth

Question 14

How often should the bag and tubing be changed?

Answer 14

q24h

Question 15

PN should be discontinued when?

Answer 15

ASAP to avoid potential complications, but not until the client’s enteral or oral intake can provide 60% or more of estimated caloric requirements?