Chapter 10- Total Parental Nutrition

Question 1

parenteral nutrition

Answer 1

used when client’s gastrointestinal tract is NOT functioning, or when client cannot physically or psychologically consume sufficient nutrients orally or enterally (Ex: cancer, patient with critical illness, trauma, burns)
- providing nutrition to blood stream through veins

Question 2

components of parenteral nutrition solution

Answer 2

• carbohydrates or dextrose
• Electrolytes, vitamins, and trace elements
• lipids
• proteins

Question 3

higher concentration of dextrose is prescribed…

Answer 3

for pt on fluid restriction

Question 4

lower concentration of dextrose is prescribed…

Answer 4

used to help control hyperglycemia

Question 5

lipids

Answer 5

used to correct or prevent essential fatty acid deficiency

-milky appearance

Question 6

how is lipid form?

Answer 6

combination of soybean oil, and/or safflower oil, and egg phospholipids

Question 7

IV lipids are contraindicated to what?

Answer 7

clients who have HYPERlipidemia, severe hepatic disease or an allergy to soybean oil eggs or safflower oil

Question 8

what solution is lipid in?

Answer 8

10%, 20%, and 30%

Question 9

what does lipid do?

Answer 9

Provides calories WITHOUT increasing PN osmolarity

Question 10

protein

Answer 10

provided as mixture of essential and nonessential amino acids

Question 11

what concentration is protein in?

Answer 11

3.5%-15%

Question 12

what determines the amount of proteins needed?

Answer 12

liver and kidney function

Question 13

which 2 medications can be added to PN solution?

Answer 13

insulin and heparin

- need a separate line for medications (do not use same line as TPN)

Question 14

what is contraindicated for IV meds?

Answer 14

administering it through PN IV line or port

Question 15

TPN used for…

Answer 15

For longer term therapy >7 days

• need intense nutritional support
• can contain up to 70% dextrose

Question 16

where is TPN administered?

Answer 16

through central vein

Question 17

PPN used for…

Answer 17

when pt unable to consume enough calories

Question 18

where is PPN administered?

Answer 18

through peripheral vein

Question 19

how should PPN solution be?

Answer 19

Solution must be isotonic, cannot contain more than 10% dextrose

Question 20

what is required on IV tubing?

Answer 20

micron filter and IV infusion pump

Question 21

how do you avoid hypoglycemia?

Answer 21

an IV of dextrose 10%-20% in water is administered if the PN solution is unavailable

Question 22

when should you change bag and tubing?

Answer 22

every 24 hours

Question 23

when should PN be discontinued?

Answer 23

Pn should be discontinued when client’s enteral or oral intake can provide 60% or more of calorie requirements
-Discontinuation should be done GRADUALLY to avoid rebound Hypoglycemia!