TPN infusions Flashcards
(21 cards)
What is parenteral nutrition?
A chemical mixture providing nutrients such as glucose, amino acids, triglycerides, electrolytes, water, and vitamins/minerals.
How is parenteral nutrition usually manufactured?
In aseptic compounding units, considering chemical and physical stability.
How many constituents does parenteral nutrition usually contain?
About 12 constituents.
What does parenteral nutrition help with?
Meets all fluid requirements via IV solution.
What is bespoke compounded parenteral nutrition?
Parenteral nutrition that meets specific individual requirements.
What is off the shelf parenteral nutrition?
Pre-made and pre-formulated parenteral nutrition, more suitable for acutely unwell patients.
How is parenteral nutrition administered?
By bypassing the GI tract and administered IV, usually via a central venous access device.
What are examples of central venous access devices (CVADs)?
PICC lines or multi-lumen CVADs.
Where is the tip of a CVAD located?
In the vena cava and right atrium of the heart.
Why can parenteral nutrition with high osmolality be given via CVAD?
Due to high blood flow volume.
Can parenteral nutrition be administered through a peripheral cannula?
Yes, but it restricts osmolality and can damage veins, leading to thrombophlebitis.
What are the risks of giving TPN?
- Surgery risks like haemorrhage. 2. Hyperglycaemia or electrolyte imbalances due to glucose content. 3. Septicaemia risk due to bacterial growth. 4. Metabolic imbalances from overriding homeostasis. 5. Requires constant monitoring and is costly.
What is enteral feeding?
Feeding through the GI tract, which is safer, cheaper, and more normal.
What can cause intestinal failure?
Damage in the small intestine, such as leaking or perforated GI tract, may necessitate TPN.
What are the three types of intestinal failure?
Type I: acute, short term, self-limiting. Type II: prolonged acute, metabolically unstable, requires PN for weeks/months. Type III: chronic, requires PN for years, can be irreversible.
What are reasons for Type I and Type II intestinal failure?
- Anastomotic leak following GI surgery. 2. Intestinal obstruction. 3. Fistula in GI tract. 4. Bowel rest or failed enteral feeding.
What should be considered before giving a patient TPN?
Whether they can be fed enterally and if the benefits of TPN outweigh the risks.
What tool can be used for nutrition screening?
The MUST tool, which helps decide if urgent intervention is needed.
What questions should be asked regarding a patient’s nutrition?
- How long has the patient been without adequate oral/enteral nutrition? 2. How long are they likely to be without adequate nutrition? 3. Assess patient’s weight and BMI. 4. What is the aim of PN?
What is the aim of parenteral nutrition?
To avoid enteral nutrition to reduce small bowel contents and fistula output.
Why might PN be required for several months?
To allow reduction of inflammation in the GI tract before surgery or healing of a fistula spontaneously.
