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OverviewTotal parenteral nutrition (TPN) is liquid nutrition given through a tube (IV) that is put in a large vein in the arm, neck, or chest. You may need TPN because of a condition that makes it hard to eat or because of a severe illness, such as Crohn's disease or pancreatitis. TPN is usually given for 12 to 14 hours each day. You may be able to get TPN while you sleep. Your doctor may recommend that a nurse visit you at home to help you get started with TPN. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take. How can you care for yourself at home?To care for your IV
To give TPN
When should you call for help?Call 911 anytime you think you may need emergency care. For example, call if:
Call your doctor or nurse call line now or seek immediate medical care if:
Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:
Where can you learn more?Go to https://www.healthwise.net/patientEd Enter Y938 in the search box to learn more about "Total Parenteral Nutrition (TPN): Care Instructions". Skip to content Total parenteral nutrition can provide an individual with the necessary nutritional support and provision of therapeutic nutrients to maintain or restore optimal nutrition status and health. Total Parenteral Nutrition bypasses the digestive system by dripping a nutritionally adequate hypertonic solution containing glucose, protein, hydrolysates, minerals and vitramins directly into the venous system through an indwelling catheter into the superior vena cava or another main vein. MACRO-NUTRIENTS:
OTHERS:
MICRO-NUTRIENTS:
A bag of TPN provides the patient with about 2270kcal nutritional intake. This high calorie intake is not considered to be too much since patients on TPN are usually fighting inflammation, requiring wound healing etc. Indications for Total Parenteral NutritionTotal Parenteral Nutrition is indicated for patients who:
DIGESTIVE DISORDERS:
NON-DIGESTIVE DISORDERS:
Contraindications for Total Parenteral Nutrition
TPN and CVCs Complications
Patient Monitoring
TPN Bag Changing Technique
Below you can find a video that can help provide a more visual approach to total parenteral nutrition. Total Parenteral Nutrition OSCE
Special thanks to the creators of the featured video on this post, specifically Youtube Channel University of Manitoba Nursing Skills. Featured image credit: https://badgut.org/information-centre/a-z-digestive-topics/parenteral-nutrition/ Did you find the above nursing information useful? Follow us on Facebook and fill in your email address below to receive new blogposts in your inbox as soon as they’re published 🙂
Claire Galea is a mum of three currently following a Degree in Nursing at the Faculty of Health Sciences, University of Malta, as a mature student. Claire is keen about public education on health-related subjects as well as holistic patient-centered care. She is also passionate about spreading awareness on the negative effects that domestic abuse leaves on its victims’ mental, emotional, social and physical wellbeing. Claire aspires to continue studying following completion of her Nursing Degree, because she truly believes in lifelong education. Claire Galea is a mum of three currently following a Degree in Nursing at the Faculty of Health Sciences, University of Malta, as a mature student. Claire is keen about public education on health-related subjects as well as holistic patient-centered care. She is also passionate about spreading awareness on the negative effects that domestic abuse leaves on its victims’ mental, emotional, social and physical wellbeing. Claire aspires to continue studying following completion of her Nursing Degree, because she truly believes in lifelong education. View all posts by Claire Post navigationWhat are the responsibilities of a TPN?Monitor blood glucose levels. Observe for signs of hyperglycemia or hypoglycemia and administer insulin as directed. (Blood glucose levels may be affected if TPN is turned off, if the rate is reduced, or if excess levels of insulin are added to the solution.) Monitor for signs of fluid overload.
What nursing measures must be carried out when a patient is receiving total parenteral nutrition?TPN should be always be administered via a smart pump with infusion safety software. Patients on continuous TPN must have the TPN bags and lines changed every 24 hours. If a patient is on 16 hourly TPN infusions, the bags and lines should be discarded at the end of each infusion.
What would be the priority nursing consideration intervention when caring for a client receiving TPN?What is the priority nursing intervention? Restart the client's infusion at another site. Slow the rate of the client's infusion of the TPN. Interrupt the client's infusion and notify the healthcare provider.
When caring for a patient who is receiving TPN?Do's and don'ts of TPN administration
Check the TPN solution against the physician's orders before hanging. Remove TPN solution from the refrigerator 30 minutes to 1 hour before infusing. Inspect the TPN solution for any precipitates or separation before infusing. Use meticulous sterile technique when handling I.V.
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