TPN Online

Question 1

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

Answer 1

sterility

Question 2

what are the two types of tpn bags

Answer 2

bespoke or off the shelf

Question 3

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

Answer 3

kabiven
triomel

Question 4

what is meant by tpn

Answer 4

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

Question 5

tpn is given iv and bypasses the

Answer 5

GIT

Question 6

tpn is given centrally via a cvab what is this

Answer 6

central venous access device

Question 7

where is the tip of the cvab located in the body

Answer 7

vena cava or right atrium of the heart

Question 8

what is the benefit of giving tpn centrally

Answer 8

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

Question 9

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

Answer 9

restricts osmolality and calories you are bale to give

Question 10

what is the risk of giving tpn peripherally via a cannula

Answer 10

damage to small veins and vessels of the hand/ arm

Question 11

give some insertion related risks that are associated with cvabs

Answer 11

pneumothorax and haemorrhage

Question 12

what are 4 risks of tpn delivery

Answer 12

septicaemia
hyperglycaemia
metabolic imbalances
fluid overload

Question 13

where does mechanical digestion start which then forms a bolus

Answer 13

in the mouth by the teeth

Question 14

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

Answer 14

chyme

Question 15

chyme passes through pylorus into

Answer 15

duodenum

Question 16

when chyme enters duodenum, gallbladder is stimulated to release

Answer 16

bile

Question 17

what does bile do to chyme

Answer 17

emulsify fats and break food into smaller particles

Question 18

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

Answer 18

ileum

Question 19

what happens to food in the jejunum and ileum

Answer 19

nutrients are extracted and absorbed

Question 20

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

Answer 20

LI

Question 21

why is feeding into gi tract/ enteral feeding always preferred

Answer 21

safe
cheap
physiologically normal

Question 22

what is meant by intestinal failure

Answer 22

non functional
inaccessible or
perforated gi tract

Question 23

how many different types of intestinal failure are there

Answer 23

3

Question 24

outline type 1 intestinal failure

Answer 24

acute
short term
resolves over a few days
self limiting

Question 25

outline type 2 intestinal failure

Answer 25

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

Question 26

outline type 3 intestinal failure

Answer 26

chronic condition metabolically stable require pn for months or years

Question 27

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

Answer 27

both

Question 28

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

Answer 28

anastomotic leak fistula in gi tract bowel rest failed enteral feeding

Question 29

what must you ask before you start tpn

Answer 29

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

Question 30

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

Answer 30

MUST

Question 31

what would you use for the slow introduction of oral fluids

Answer 31

water

Question 32

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

Answer 32

monitor drain output and confirm healing

Question 33

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

Answer 33

false

Question 34

pn required for several months to allow either X or Y

Answer 34

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

Question 35

what to consider abt px risk before tpn

Answer 35

risk of malnutrition