Card Set Information
Highly stressed physiological states such as _____ benefit from PN.
Never use an _____ IV site to give PN.
Always use a new site to decrease the risk of infection
2L of PPN delivers up to _________kcal/day.
10% dextrose with 10% amino acids (supplimented by 500 mL of fat emulsion piggy-backed BELOW the filter)
Why is PPN difficult to maintain?
Because of frequent episodes of phlebitis and infiltration.
How are lipids stored?
At room temperature
It should look like milk
No separation or oily substances
Where are Lipids attached to the IV line?
Below the filter if it is smaller than 1.2 micron size
Fat particles are large and would break down passing through a filter smaller than 1.2 micron
PPN is given through ______.
A PICC line or IV
_____ contains a mixture of carbohydrates (10-70% dextrose), amino acids (protein/nitrogen), fats, electrolytes, vitamins & trace minerals (zinc, copper, maganese, and chromium)
What three meds can pharmacy add to TPN?
Goals of PN
Ideal weight gain-1 to 3lbs a week
Serum glucose levels - maintained between 80-110 mg/dL or <150
When can clients PN be reduced by 1/2?
Once they are meeting 1/3 - 1/2 of their kcal needs per day via enteral route
When is PN discontinued?
When the patient is meeting 75% of their kcal needs via enteral route.
How often do you monitor the flow rate of PN?
How often do you monitor glucose for pts recieving PN?
Change TPN tubing q _____.
Do not allow lipids to hang for more than ____.
Why are TPN pts at risk for Vitamin K deficiency?
Vitamin K is synthesized in the GI tract.
Must supplement TPN pts
If TPN runs dry what do you do?
Hang at least 10% dextrose until more TPN is available. Prevents hypoglycemia.
Lipids are a/an ______ solution.
_____ do NOT have to be filtered?
Lipids, they have no sediment
How do you start and run TPN?
Start slow then increase
TPN is a hypertonic solution
How are lipids ran?
They start at 21mL/hr and run at 12 mL/hr
PN with greater than 10% dextrose requires a _____.
Suspect _______ if client develops fever, chills, and glucose intolerance.
What is refeeding syndrome?
When concentrated glucose is given and is accompanied by increases in endogenous insulin production (K, mag, phosphorus) move intracellularly).
In malnourished pts this results in low serum extracellular levels of electrolytes and edema causes cardiac dysrhythmias, CHF, resp distress, convulsions, coma, or death.