TPN - Advanced Med Surg Concepts
TPN (total parenteral nutrition) - (correct Answer) - TPN provides the total nutrition the body requires
while bypassing the GI tract
helps maintain electrolyte and acid-base balance, for TPN, blood work is usually done daily or q6h to get
accurate daily values
used for patients experiencing GI dysfunction, medical or surgical conditions or until the patient can
resume oral diets or feeds via an enteral tube
The components of parenteral nutrition include:
amino acids, glucose, proteins, carbs, lipids (+/-), trace elements, vitamins and minerals
Infusion principles - (correct Answer) - Infused for: obstructions, bowel surgery, trauma, paralytic ileus
Types of catheters for infusion depends on the length and type of parenteral nutrition administered
(PICC, Port, Central line)
Due to the high osmolality of the solution, it cannot be infused via peripheral intravenous
TPN must be infused via IV pump
NOT compatible with any other solutions or medications
requires a special filter on IV tubing to prevent particles from entering the blood stream
bags are mixed by pharmacy and verified by nursing staff before admin
do not pause infusion of TPN
use alternate location for med admin and blood draws
TPN should not exceed 24 hours
, if solutions are refrigerated, remove 1 hour prior to admin
amino acids - (correct Answer) - building blocks of proteins
for TPN they typically come in 1000 or 2000ml bags and are yellow in colour due to added vitamins
lipids - (correct Answer) - fats
for TPN they are milky white in colour and come in 100-250ml bags
should not hang for longer than 12 hours
s/s of an allergy to lipids:
elevated triglyceride levels, n/v, fever, chills, vertigo, dyspnea, flushing
Hypoglycemia - (correct Answer) - abnormally low level of sugar in the blood
a potential complication of abrupt d/c of TPN
pts need to be weaned off when d/c to avoid this
hyperglycemia - (correct Answer) - excessive sugar in the blood
also linked to TPN, regular glucose monitoring is required even if the pt isn't a diabetic
glucs are usually taken q6h
I&O must also be routinely measured
TPN orders - (correct Answer) - Usually ordered in collaboration with the physician and dietician based
on the pts needs and their lab values
should not be d/c until at least 60% of the patient's nutritional needs are being met either orally or
enterally
TPN monitoring - (correct Answer) - fluid intake q8h
vital signs q4h
weight x3 weekly
glucs q6h
TPN (total parenteral nutrition) - (correct Answer) - TPN provides the total nutrition the body requires
while bypassing the GI tract
helps maintain electrolyte and acid-base balance, for TPN, blood work is usually done daily or q6h to get
accurate daily values
used for patients experiencing GI dysfunction, medical or surgical conditions or until the patient can
resume oral diets or feeds via an enteral tube
The components of parenteral nutrition include:
amino acids, glucose, proteins, carbs, lipids (+/-), trace elements, vitamins and minerals
Infusion principles - (correct Answer) - Infused for: obstructions, bowel surgery, trauma, paralytic ileus
Types of catheters for infusion depends on the length and type of parenteral nutrition administered
(PICC, Port, Central line)
Due to the high osmolality of the solution, it cannot be infused via peripheral intravenous
TPN must be infused via IV pump
NOT compatible with any other solutions or medications
requires a special filter on IV tubing to prevent particles from entering the blood stream
bags are mixed by pharmacy and verified by nursing staff before admin
do not pause infusion of TPN
use alternate location for med admin and blood draws
TPN should not exceed 24 hours
, if solutions are refrigerated, remove 1 hour prior to admin
amino acids - (correct Answer) - building blocks of proteins
for TPN they typically come in 1000 or 2000ml bags and are yellow in colour due to added vitamins
lipids - (correct Answer) - fats
for TPN they are milky white in colour and come in 100-250ml bags
should not hang for longer than 12 hours
s/s of an allergy to lipids:
elevated triglyceride levels, n/v, fever, chills, vertigo, dyspnea, flushing
Hypoglycemia - (correct Answer) - abnormally low level of sugar in the blood
a potential complication of abrupt d/c of TPN
pts need to be weaned off when d/c to avoid this
hyperglycemia - (correct Answer) - excessive sugar in the blood
also linked to TPN, regular glucose monitoring is required even if the pt isn't a diabetic
glucs are usually taken q6h
I&O must also be routinely measured
TPN orders - (correct Answer) - Usually ordered in collaboration with the physician and dietician based
on the pts needs and their lab values
should not be d/c until at least 60% of the patient's nutritional needs are being met either orally or
enterally
TPN monitoring - (correct Answer) - fluid intake q8h
vital signs q4h
weight x3 weekly
glucs q6h
