Parenteral Nutrition
This nutrition is started as a continuous 24 hour infusion.
What is parenteral nutrition?
Initial tube placement should be confirmed with this before the instillation of feeding, fluids, or medications.
What is an x-ray
Condition of blood glucose >180 mg/dL
What is hyperglycemia.
The Centers for Disease Control (CDC) defines a ________ as a “catheter which terminates in one of the great vessels in or near the heart and be used for one of the purposes: infusions, withdrawal of blood and hemodynamic monitoring” (2013).
central venous access device (CVAD)
These meds should never be crushed
What are enteric coated or extended release medications
If parenteral nutrition (PN) is needed for an extended period of time, _______PN is utilized.
What is cyclic?
Syringe used to flush and administer medications to the enteral tube
ENFit syinge
5 Risks for hyperglycemia on PN (parenteral nutrition).
What are: age, obesity, severity of illness, rate of infusion, h/o diabetes.
This is a tube placed with the intension of decompressing the bowel until normal peristalsis returns in the case of ileus or bowel obstruction. (specific name of tube)
What is a Salem or Levin NG tube
These complications can result in ______.
Skin flora migration in short-term use
Contamination of catheter hub in long-term use.
What is Infectious complication.
Cyclic PN is given over ____-____ hours, overnight.
What is 8-16?
Enteral feeding for use in patients with impaired glucose tolerance (e.g., diabetic patients)
What is Glucerna
The abrupt discontinuation of PN or TPN can cause this.
What is hypoglycemia.
This tube goes from the nose to the stomach
What is a Naso Gastric Tube (NG)
A nasoduodenal tube would be placed from the nose to the duodenum (first part of small intestine)
A nasojejunal tube would be place from the nose to the jejunum (second part of the small intestine)
It is important to know where the tip of the tube lies
Amount of suction in mmHg is considered low suction
usually 80 to 100 mmHg = low suction
PN may be discontinued when ____% of nutritional needs are met.
What is 60%?
Amount of time the syringe and graduate cylinder used for flush of enteral tube should be replaced.
What is every 24 hours
This is administered to control blood glucose levels, due to the dextrose in PN and TPN.
What is insulin.
This tube is surgically placed in the stomach for feedings.
What is a G tube (gastrostomy tube)
or PEG tube (percutaneous endoscopic gastrostomy tube)
A tube could also be surgically placed in the jejunum or second part of the small intestine (Jejunostomy tube=J tube or PEJ)
CLABSI
What is central line associated bloodstream infection?
Most common non-infectious device complication.
What is catheter occlusion?
If the nurse obtains this residual amount, the enteral feeding should be stopped and provider called.
>500 mL
or >250 mL times 2 checks
______ concentration is increased gradually over several days in parenteral nutrition.
What is Dextrose?
This tube goes into the _____ or _____ for what is called postpyloric feeding because the distal end of the feeding tube rests past the pylorus.
what is the duodenum or jejunum
Amount of air injected into the blue air vent "pigtail" of the NG tube used for suction following each irrigation or flush of the NG tube