TPN and PPN Info
What type of vascular line is used for TPN?
A Central Line
Inability to meet nutritional demands
This is the primary component of lipid emulsions in TPN
Fats
How fast can you increase the rate of TPN by if you fall behind?
NONE!
How frequently do you exchange TPN tubing?
Q24 Hours
This is the type of line used to administer PPN
Inflammatory bowel disease are an indication for TPN, true or false?
True!
What syndrome can develop from too many lipids?
What can you do while you are waiting for TPN to be made and mixed?
Administer D10 or D20
This device goes on the end of all TPN lines
0.2 micron filter
This is the main PHYSICAL assessment for a patient receiving PPN
IV damage, extravasation
Name 4 electrolytes given in TPN
Na, K, Ca, Mg, Phosphorus,
How long does a lipid bag hang for?
12 hours
This technique is used to mix vitamins
Sterile Technique
A nurse is adminstering TPN into a 14G R AC IV. Patient has been recieving administration for 2 days this way. Glucose is 106 and Na is 142. This is the thing the nurse must correct in the scenario
CENTRAL LINE ONLY
This is the reason a patient may receive PPN instead of TPN
They can eat but not enough to meet their nutritional demands
Name 3 diseases that would require TPN (As listed in slide)
•Severe malnutrition
GI disorders that prevent absorption of nutrients
Severe burns
Inflammatory bowel diseases
Cancer
Intestinal obstruction/perforation
How frequently are tubing and filter changed for lipids?
Q12H
This is the minimum frequency of glucose checks with TPN
Q6H
This action must always be taken before administering TPN and after administration is finished.
Flush the line!
What tubing protocols are used when administering PPN?
Lipid tubing protocols, Change Q12H
What are the two contraindications for TPN?
Kidney/liver Impairment and uncontrolled diabetes.
Name two symptoms of fat overload syndrome
This assessment finding would be indicative of fluid overload in a patient receiving TPN
Crackles, Pulmonary edema, or cough with pink frothy sputum
This electrolyte will typically be elevated in TPN
Calcium