Administration
Infection Prevention
Safety Pearls
Parenteral Nutrition Facts
Double Jeopardy
100

Can PN be infused with any other medications?

  • No, PN is typically not compatible with other infusions
100

What is the appropriate amount of time needed to scrub the needles connector for?

5-15 seconds vigorously 

100

Do you need to stop/pause PN to give another infusion if there is a 2 lumen PICC/CVL?

No, double lumens mean its safe to infuse two infusions at the same time without the worry if interactions.

100

What is another name TPN, PPN and Lipids referred to as?

What is Parenteral Nutrition

200

What 3 things do you need to verify with two nurses before administering PN?

Original provider order in the eMAR against the bag

Rate to be input on pump

Designated initiation time and end time for each infusion

200

What is Aseptic Non-touch Technique applied to Parenteral Nutrition set up?

Framework that supports infection prevention

200

What type of medication is PN classified by ISMP?

High risk medication

200

What is TPN/PPN, and Lipids?

Type of intravenous administration of nutrition outside of the gastrointestinal tract to meet Nutrional needs and fluid goals

300

What type of tubing add on should be used when administering PN?

TPN 0.2 micron filter (clear/white) and Lipids is 1.2 filter (blue)

300

Is changing the needles connectors on a CVL/PICC a sterile or clean procedure?

Clean; use aseptic non touch technique

300

What can happen to a patient if PN abruptly discontinue?

Risk for hypoglycemia

300

Name two indications for Parenteral Nutrition

  • NPO for extended periods of time
  • Bowel Rest r/t obstructions or surgery
  • Impaired gastric function
  • Unable to maintain nutritional status
300

What is a most common complications of Parenteral Nutrition?

CLABSIs

400

What time is PN usually set up for patients at ANMC?

Typically, 5 pm as early as 4. Variables can be present depending on the patient specifics

400

What is 3 things are typically changed out when doing a changeover for PN?

Needless connector or microclave, Bags, IV Lines

400

What is one of the most important aspects to check before administration of PN

Access; flush CVL or PIV to make sure its patent

400

Parenteral Nutrition should be stored and administered under this condition to prevent degradation due to its multivitamin content

Protected from light; keep the brown bag it comes with

400

How long can a patient go without food before PN is initiated?

7 days

500
  • How do you connect IV lines to the patient?
  • Use TPN as the main line and attach lipids line to the TPN below the TPN filter
500

Why does TPN/PPN/Lipids need to be changed out daily?

  • Due to the high concentration of dextrose and fat in the lines/bags to reduce infection related to bacterial growth
500

What do you anticipate to do if the PN is disconnected by accident on the patient?

Notify the provider and get an order for an IV fluid; usually a D10 type mixture. Some D5 infusions can be used

Follow up Glucose level

500

What is the difference between TPN and PPN

  • Dextrose concentration: TPN has dextrose concentration of 12.5%  or higher while PPN has dextrose concentration of 12.5% or lower
  • Osmolarity
  • TPN > 900; PPN < 900; vesicant to the vein
500

What are the names of two organizations responsible for the best practices in the administration/infusion of Parenteral Nutrition? 

Infusion Nurses Society (INS) and the American Society for Parenteral and Enteral Nutrition (ASPEN)