1 / 18

Ch. 21: Parenteral Nutrition

Ch. 21: Parenteral Nutrition. Parenteral Nutrition: Delivery of nutrient solutions directly into a vein, bypassing the intestinal tract IV Nutrition can be tailored to individual needs Can provide water, amino acids, carbohydrate, fat and micronutrients.

Download Presentation

Ch. 21: Parenteral Nutrition

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Ch. 21: Parenteral Nutrition • Parenteral Nutrition: Delivery of nutrient solutions directly into a vein, bypassing the intestinal tract • IV Nutrition can be tailored to individual needs • Can provide water, amino acids, carbohydrate, fat and micronutrients

  2. Rationale for Determining Feeding Route

  3. Parenteral Nutrition • Advantages • Can provide total nutritional support for longer period of time • Disadvantages of Parenteral Nutrition • Costly • Complications • Sepsis • Liver • Kidneys • Bone disorders • Deficiencies

  4. Parenteral Solutions, cntd. • Intravenous nutrients • Amino acids: essential and nonessential (branch-chained and aromatic) • Carbohydrate: dextrose 3.4 kcal/gm • Lipids: LCT or MCT, EFAs • Micronutrients: prevention of deficiencies

  5. Types of Intravenous Formulataions • Types Intravenous Solutions • Simple • simple IV solutions typically contain 5 percent dextrose and/or normal saline (Normal saline is a solution of sodium and chloride in water) • other electrolytes or salts may be added • Types Intravenous Solutions • Complete • complete nutrient solutions provide amino acids, dextrose, fatty acids, vitamins, minerals, and trace elements • can be delivered into peripheral veins (the small-diameter veins that carry blood from the arms and legs) or central veins (the large-diameter veins located close to the heart)

  6. Simple Intravenous Infusions • used in medical conditions that disrupt acid base balance or fluid and electrolyte balance • are delivered via a IV catheter through a peripheral forearm vein • An IV catheter is a thin tube inserted into a peripheral or central vein. Additional tubing connects the IV solution to the catheter

  7. Peripheral vs Total Parenteral Nutrition • Compare the composition and uses of PPN andTPN • Peripheral Parenteral • Nutrition (PPN) • Isotonic formula • Contains all essential nutrients • Requires renal functioning • Short-term: 7-14 days • Additional support for enteral feedings • Used when TPN not possible

  8. PPN and TPN, cntd. • Total Parenteral Nutrition (TPN) Central Vein • IV catheter in large central vein • Highly concentrated solutions • Long-term use • High nutritional needs • Client is severely malnourished • Higher risk of infection

  9. IV Nutrition • What risks are associated with IV Nutrition? • IV Nutrition Risks • TPN requires surgical placement • Peripheral veins—inflammation & infection • TPN: Disease causing microorganisms introduced • Complications on p. 526

  10. IV Nutrition • Proper way to administer PPN and TPN solutions • PPN: Peripheral veins can collapse if concentration too high • TPN: Feeding started slowly because of high glucose content and high osmolality of solutions • Infusion pump required • Hypoglycemia & hyperglycemia risks • Electrolytes monitored vigilantly

  11. Transition from Parenteral to Enteral Nutrition • Appropriate transition from parenteral to enteral nutrition • Villi will shrink and lose ability to function as a result of nonuse • Slow reintroduction of enteral nutrition • Transitional Feedings • TPN tapered off gradually • PPN doesn’t require tapering off

  12. Transitioning, cntd. • Rule of Thumb 1: • If clients can’t eat enough food to meet at least 50% of daily nutritional needs tube feedings should be considered. • Rule of Thumb 2: • Parenteral nutrition can be discontinued when at least 70-75% of energy needs are being met by oral intake, tube feedings or both

  13. Home Nutrition Support • Identify the benefits of and the criteria used to select candidates for home nutrition support • Medical considerations • Rational, stable personality • Learning techniques, handling complications • Compliant with recommendations • Adequate financial resources & support

  14. Practice Questions • Types of formulas that contain complete proteins are called: • Intact • Hydrolyzed • Modular • Blenderized

  15. Hydrolyzed formulas are given to clients who are able to digest and absorb nutrients without difficulty. • True • False

  16. The primary purpose of a simple IV solution is to support all of the following EXCEPT: a. Help maintain fluid and electrolyte balance b. Help maintain adequate nutrient intake c. Help restore acid-base balance

  17. Ideally a person should reach a severely-depleted state before TPN by central vein is initiated. • True • False

More Related