Line Logic
True or False: Labs should be drawn from the same lumen used for TPN
False
Verifying Blood return confirms this
that the catheter is properly positioned in the vein and that there is no blockage
How often should primary IV tubing be changed for continuous infusions?
Primary IV set (If it has stayed connected the entire time) Every 7 days according to Blessing Hospital Policy.
What does TPN stand for?
What is Total Parenteral Nutrition?
When using the patient/resident own parenteral nutrition, what does the nurse need to do first?
Get the consent form signed
*You can only use the patient/resident PN if the patient/resident signs the consent form
What should you verify in the order before proceeding with a draw?
What is that lab collection from a central line is permitted?
Why is it critical to follow policy for waste volume?
What is to ensure sample accuracy and patient safety?
How often should primary IV tubing be changed if it has been disconnected?
What is every 24 hours
What life-threatening metabolic complication can occur if TPN is stopped abruptly?
What is hypoglycemia?
Lipids can be Y connected below the TPN filter using what size micron filter to prevent fat embolisms
What is 1.2 microns?
To prevent CLABSI's, do this to ensure blood is cleared and access points remain clean
Blue cap
Needless injection port
After blood is drawn for testing, flush with how much of this using pulsatile flush.
What is with 20mL normal saline
Why is it important to label IV tubing with the date and time of change?
What is to ensure timely maintenance and reduce infection risk?
What is the purpose of the in-line 0.22-micron filter used with TPN?
What is to remove bacteria and particulate matter from non-lipid TPN solutions?
Name 2 clinical or laboratory signs that suggest fat overload syndrome during lipid infusion
What is hypertriglyceridemia (Elevated TG levels) and acute fever
Resource: NIH- "Fat overload syndrome after the rapid infusion of lipid emulsion"
Doing this removes residual saline, heparin, or other infused solutions that could dilute or alter lab results
What is wasting 5 ml of blood from the central line
You are doing bedside shift report and notice your patient/resident's tubing has been in place for 30 hours, and the infusion appears clear with no signs of contamination. What should your next action be?
Change all TPN tubing immediately-TPN tubing must be replaced every 24 hours to reduce the risk of infection. CLABSI
Or ask the RN you are doing bedside shift report with to please change out the tubing :)
Your patient/resident is receiving TPN suddenly develops shortness of breath, chest pain, and a drop in oxygen saturation. What is your priority action?
Pause the TPN infusion
Place the patient/resident in Trendelenburg on the left side (Traps air in the right atrium)
Administer oxygen
Notify Provider
Call a RAPID
This might be an air embolism