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Finals > TPN Online > Flashcards

TPN Online Flashcards

1
Q

in a tpn bag there are up to 12-15 constituents therefore chem stability and X are key

A

sterility

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2
Q

what are the two types of tpn bags

A

bespoke or off the shelf

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3
Q

off the shelf parenteral nutrition bags are pre made and pre formulated with various different ones for you to select give 2 examples

A

kabiven
triomel

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4
Q

what is meant by tpn

A

all macronutrient, micronutrient and fluid requirements are met by iv nutrient solution and none obtained from other sources

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5
Q

tpn is given iv and bypasses the

A

GIT

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6
Q

tpn is given centrally via a cvab what is this

A

central venous access device

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7
Q

where is the tip of the cvab located in the body

A

vena cava or right atrium of the heart

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8
Q

what is the benefit of giving tpn centrally

A

volume of blood flow, pn can be given with high osmolality without problems

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9
Q

some hospitals will give tpn peripherally, what is the drawback of this

A

restricts osmolality and calories you are bale to give

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10
Q

what is the risk of giving tpn peripherally via a cannula

A

damage to small veins and vessels of the hand/ arm

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11
Q

give some insertion related risks that are associated with cvabs

A

pneumothorax and haemorrhage

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12
Q

what are 4 risks of tpn delivery

A

septicaemia
hyperglycaemia
metabolic imbalances
fluid overload

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13
Q

where does mechanical digestion start which then forms a bolus

A

in the mouth by the teeth

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14
Q

the bolus goes down oesophagus into stomach which churns food, chemical digestion starts and turns the bolus into a liquid called

A

chyme

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15
Q

chyme passes through pylorus into

A

duodenum

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16
Q

when chyme enters duodenum, gallbladder is stimulated to release

A

bile

17
Q

what does bile do to chyme

A

emulsify fats and break food into smaller particles

18
Q

pancreas is stimulated to release enzymes to break food down further, chyme gradually moves through jejunum and

A

ileum

19
Q

what happens to food in the jejunum and ileum

A

nutrients are extracted and absorbed

20
Q

which structure reabsorbs water and waste products are passed out through the rectum and the anus

A

LI

21
Q

why is feeding into gi tract/ enteral feeding always preferred

A

safe
cheap
physiologically normal

22
Q

what is meant by intestinal failure

A

non functional
inaccessible or
perforated gi tract

23
Q

how many different types of intestinal failure are there

A

3

24
Q

outline type 1 intestinal failure

A

acute
short term
resolves over a few days
self limiting

25
Q

outline type 2 intestinal failure

A

prolonged acute condition
metabolically unstable patients
pn required for weeks or months

26
Q

outline type 3 intestinal failure

A

chronic condition
metabolically stable
require pn for months or years

27
Q

is type 3 intestinal failure reversible, irreversible or can it be both

A

both

28
Q

give some common indications for type 1 and type 2 IF which would prompt pn

A

anastomotic leak
fistula in gi tract
bowel rest
failed enteral feeding

29
Q

what must you ask before you start tpn

A

can patient be fed enterally (always preferred)
if not why not
do benefits outweigh the risks

30
Q

patients risk of malnutrition should be assessed using a screening tool, name one

A

MUST

31
Q

what would you use for the slow introduction of oral fluids

A

water

32
Q

what would you use as a guide to know that tpn can be withdrawn

A

monitor drain output and confirm healing

33
Q

true or false, you do not need to determine the aim of pn from the outset

A

false

34
Q

pn required for several months to allow either X or Y

A

reduction of inflamm then surgery to close fistula
reduction of inflamm and healing of fistula

35
Q

what to consider abt px risk before tpn

A

risk of malnutrition

Finals (30 decks)

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