Level Up RN - Parenteral Nutrition

Overview

• Parenteral nutrition delivers nutrients via IV into the patient's vein, bypassing the gastrointestinal tract.
• Total parenteral nutrition (TPN) is administered through a PICC line or a central venous catheter.
• Used in cases of malabsorption, malnutrition, hypermetabolic states, or prolonged NPO status.

Indications for Parenteral Nutrition

• Malabsorption and malnutrition.
• Hypermetabolic state.
• Prolonged NPO status.
• Example: Cathy received TPN during pregnancy due to severe hyperemesis.

Nursing Care for TPN

• Check ingredients against provider’s orders: Verify with label and often require a second nurse check.
• Use of IV tubing with a filter: Change tubing and bag every 24 hours.
• Monitor closely: Intake and output, daily weight, electrolyte levels, and blood glucose levels.
• TPN Line Use: Never administer other fluids or medications through the TPN line; it’s dedicated just for TPN.
• Adjusting flow rate: Increase or decrease gradually to prevent hyperglycemia or hypoglycemia.
• If TPN bag is delayed: Administer 10-20% dextrose in water to prevent blood glucose from dropping.

Quiz Questions

1. Frequency of changing TPN tubing and bag: Every 24 hours.
2. Fluids through TPN line: False - No other fluids or medications should be administered.
3. Action if TPN bag is delayed: Administer 10-20% dextrose in water.

Additional Tips

• Pay close attention to bold red text in flashcards; they often contain crucial exam information.

Conclusion

• Comprehensive nursing care and adherence to guidelines are critical when administering TPN.
• Stay updated and prepared for questions related to TPN in nursing exams.