100% of participants will be able to administer parenteral nutrition.
CEUFast, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. ANCC Provider number #P0274.
100% of participants will be able to administer parenteral nutrition.
After completing this continuing education course, the participant will be able to meet the following objectives:
Parenteral nutrition (PN) is feeding nutritional products IV. The usual process of eating and digestion is bypassed.
PN is indicated for the following conditions(Nettina, 2019):
PN Type (Nettina, 2019) | Composition | Notes |
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Total nutrient admixture (TNA) |
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Peripheral parenteral nutrition (PPN) |
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Total Parenteral Nutrition (TPN) |
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TNA (Nettina, 2019):
TPN and lipids may be given intermittently or mixed together
Fat Emulsion (Lipids)
A filter should be used if possible. A 0.22-micron filter is used for PN without lipids.
A 1.2-micron filter is used for TNA with lipids.
PN cannot be administered with any other solutions, medications or blood.
When changing tubing in a central line, have the patient perform a Valsalva maneuver to prevent air from being sucked into the tubing.
Tubing used for parenteral nutrition should be changed every 24 hours. Tubing for fat emulsion infusion must be changed every 12 hours. Use strict sterile technique when changing tubing or dressings.
Check frequently for tolerance and complications.
Complications
Complication (Nettina, 2019) | Causes | Monitor for signs | Intervention |
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Sepsis |
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Electrolyte imbalance |
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Hyperglycemia |
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Hypoglycemia |
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Hypervolemia |
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Hyperosmolar diuresis |
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Hepatic dysfunction |
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Hypercapnia |
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Lipid intolerance |
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Lipid particulate aggregation |
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Long-term VADs
A multi-lumen central VAD allows concomitant administration of PN and other solutions, including medications or blood. The different lumens do not mix because the lumens end at different lengths along the catheter. So, the two lumens are infusing at different locations.
CEUFast, Inc. is committed to furthering diversity, equity, and inclusion (DEI). While reflecting on this course content, CEUFast, Inc. would like you to consider your individual perspective and question your own biases. Remember, implicit bias is a form of bias that impacts our practice as healthcare professionals. Implicit bias occurs when we have automatic prejudices, judgments, and/or a general attitude towards a person or a group of people based on associated stereotypes we have formed over time. These automatic thoughts occur without our conscious knowledge and without our intentional desire to discriminate. The concern with implicit bias is that this can impact our actions and decisions with our workplace leadership, colleagues, and even our patients. While it is our universal goal to treat everyone equally, our implicit biases can influence our interactions, assessments, communication, prioritization, and decision-making concerning patients, which can ultimately adversely impact health outcomes. It is important to keep this in mind in order to intentionally work to self-identify our own risk areas where our implicit biases might influence our behaviors. Together, we can cease perpetuating stereotypes and remind each other to remain mindful to help avoid reacting according to biases that are contrary to our conscious beliefs and values.