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  • TPN 01 11

    Diunggah oleh

    Hisham Maassarani
    35 tayangan6 halaman
    A patient with Chron's disease is receiving TPN via a subclavian triple lumen catheter. The nurse recognizes that a priority is to: 1. Assess the insertion site for signs of infection 2. Complete the administration within 8 hours 3. Discontinue infusion if patient becomes hyperglycemic 4. Change IV tubing and dressing every 72 hrs.

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    TPN_01_11

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    A patient with Chron's disease is receiving TPN via a subclavian triple lumen catheter. The nurse recognizes that a priority is to: 1. Assess the insertion site for signs of infection 2. Complete the administration within 8 hours 3. Discontinue infusion if patient becomes hyperglycemic 4. Change IV tubing and dressing every 72 hrs.

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    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    35 tayangan6 halaman

    TPN 01 11

    Diunggah oleh

    Hisham Maassarani
    A patient with Chron's disease is receiving TPN via a subclavian triple lumen catheter. The nurse recognizes that a priority is to: 1. Assess the insertion site for signs of infection 2. Complete the administration within 8 hours 3. Discontinue infusion if patient becomes hyperglycemic 4. Change IV tubing and dressing every 72 hrs.

    Hak Cipta:

    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 6

    1/23/2011

     Mixture
     Specifically designed—
    individualized
     Sugar, carbs, protein,
    lipids, electrolytes, trace
    elements
     Should be clear—no
    sediment

    N250 Dr. Dahlen

     Can’t eat
     Needs nutritional support
     Cancer patient; transplant patient;
    stabilization of electrolytes in the elderly

    1
    1/23/2011

     Sodium  Does having too much or too little of any


     Potassium electrolyte have the potential to cause health
     Chloride problems?
     Phosphate  Give an example
     Calcium
     Magnesium

     If you have a patient who is already  Could you see an EKG changes? Why? What
    nutritionally challenged and you are giving specifically?
    them a solution of electrolytes via a central  Could you see issues with muscle strength?
    line, what signs and symptoms would you Why? What specifically?
    observe for?  Could you see any problems with mental
    status? Why? What specifically?

    2
    1/23/2011

     Hyperkalemia may cause spiked “T” waves  Hypocalcemia


     Chvostek’s Sign
     Trousseau’s

    www.sohnurse.com

     Hypomagnesemia  Mouth sores; skin changes; *fever, chills,


     Mental status stomach pain, *SOB, rapid wt. loss or gain;
     changesbehavior/sedation/confusion muscle weakness or twitching, jumpy
    reflexes, swelling of hands or feet
     What type of patient do you think TPN
    should be use cautiously with?

    3
    1/23/2011

     Renal  Electrolytes
     Cardiac Insufficiency  Kidney specific
     Diabetics  ?Infection at site of central line? WBCs
     Remember: Fluid overload (report SOB/  Blood glucose
    rapid wt. gain/swelling of hands and feet).
     Hypokalemia: ESRD and poor nutrition
    coupled with extra fluid, sodium, potassium.
     And TPN has a lot of glucose packed with
    particles!

     Should be kept in fridge or freezer  A patient with Chron’s disease is receiving


     Remove 4-6 hours before giving (why)? TPN via a subclavian triple lumen catheter.
     Do not refreeze The nurse recognizes that a priority is to:

    1. Assess the insertion site frequently


    2. Complete the administration within 8 hours
    3. Discontinue infusion if patient becomes
    hyperglycemic
    4. Change IV tubing and dressing every 72 hrs.

    4
    1/23/2011

     A patient with Chron’s disease is receiving  Infection is a major concern for clients
    TPN via a subclavian triple lumen catheter. receiving TPN
    The nurse recognizes that a priority is to:  Usually given continuous drip
     Never stop abruptly (hyPOglycemia
    1. Assess the insertion site for signs of infection  Change bag each time and dsg. Per policy
    2. Complete the administration within 8 hours
    3. Discontinue the infusion if the patient experiences
    hyperglycemia
    4. Change the IV tubing and dressing every 72 hrs.

    Coonan, P.R. (2006). NCLEX for dummies .

     When caring for a patient who is receiving  When caring for a patient who is receiving
    TPN, what should the nurse do to prevent TPN, what should the nurse do to prevent
    infection in the patient? infection in the patient?
    1. Encourage the patient to take fluids by 1. Encourage the patient to take fluids by
    mouth each day mouth each day
    2. Monitor the serum blood urea nitrogen and 2. Monitor the serum blood urea nitrogen and
    blood sugar daily blood sugar daily
    3. Maintain strict I&O records 3. Maintain strict I&O records
    4. Use strict aseptic technique when caring for 4. Use strict aseptic technique when caring for
    the IV site the IV site

    5
    1/23/2011

     A patient is started on TPN. Which of the  A patient is started on TPN. Which of the
    following lab tests should the nurse monitor following should the nurse monitor to
    several times a day? determine hydration status?
    1. Serum calcium and magnesium a. Serum calcium and magnesium
    2. Urine specific gravity b. Urine specific gravity
    3. Blood glucose c. Blood glucose
    4. Serum total protein d. Serum total protein

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