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NURS232-UNIT I, I
LAMARTINA TPN/PPN
| Question | Answer |
|---|---|
| TPN/PPN is indicated when the body is in what type of state? | hypermetabolic |
| trauma, burns and cancer patients may require TPN/PPN because they may cause? | hypermetabolic states |
| patients with impaired nutritional status are at high risk for complications from what? | surgery or anesthesia |
| hypermetabolic states may affect healing, clotting and result in a negative ____ ______ | nitrogen balance |
| tpn/ppn are very _____ solutions | hypertonic |
| the preferential route for total parenteral nutrition is through a | central line |
| a patient on fluid restrictions should not receive | peripheral parenteral nutrition |
| for a patient with a caloric need of 1500 calories a day will more than likely be placed on | peripheral parenteral nutrition |
| a patient that requires more than 2000 calories a day will more than likely be placed on | total parenteral nutrition |
| TPN and PPN have the same ___ with different ___ | composition; concentrations |
| parenteral nutrition with a high concentration of dextrose should be given through what type of line? | central |
| what is the maximum percentage of dextrose in a solution given via periheral lines? | twelve |
| the higher the osmolarity of the solution the more ____ it is | hypertonic |
| three percent amino acids in a parental nutrition solution should be given through a ____ line | central |
| 1 gm of dextrose equals __ calories | 3.4 |
| 1 gm of protein equals __ calories | 4 |
| 1 gm of fat equals __ calories | 9 |
| TPN with lipids will require what size of micron filter? | 1.2 |
| TPN without lipids will require what size of micron filter? | 0.2 |
| the micron filter needed for tpn with out lipids is ___ than the filter needed for tpn with lipids | smaller |
| lipids included in tpn requires a __ micron filter | larger |
| lipids are ___ than the other components of tpn/ppn | larger |
| if lipids are piggybacked with tpn/ppn they should be hung above or below the filter? | below |
| why don't you hang lipids in a way that they would run through the tpn filter? | they won't filter throught because they are too large |
| what is the most important thing to assess regarding tpn at the beginning of a shift | how much tpn is left and when it will need to be replaced |
| how often are tpn bags & tubing replaced | q 24hrs |
| why do we replace tpn bags & tubing so often? | to reduce the risk for infection because bacteria love dextrose |
| when preparing to enter a room to assess an IV site what should you bring with you in addition to the dressing and materials needed to change the dressing? | culture swabs |
| how long can tpn sit at room temp? | 30 minutes |
| after removing the tpn from the refrigerator how soon can you infuse it? | 30 minutes |
| can you hang tpn that has just been pulled from the refrigerator? | no |
| what four ongoing assessments are important when administering tpn? | blood sugar, iv site, I&O, daily weights |
| if a decrease in urine is detected in a patient receiving tpn/ppn what should you check? | blood sugar |
| a decrease in urine would indicate what level of blood sugar? | high |
| hot and dry, sugar's __ | high |
| hyperglycemia --> ____ _____ --> ______ | osmotic diuresis; dehydration |
| what should you have stocked on the floor if a patient is receiving tpn/ppn? | D10 |
| carbs --> H20 + CO2 --> _____ state | acidotic |
| an acidotic state is manifested by | respiratory distress |
| a complication of tpn therapy caused by carbohydrates | respiratory distress |
| what action should you take if a patient is showing signs of respiratory distress | leave tpn running, get a bs and call the dr |
| should you stop tpn if a patient experiences an increase in urine output or respiratory distress? | no |
| how should tpn be discontinued? | gradually |
| tpn should be discontinued over _____ | 4-6 hours |
| what will be assessed every 2 hours while weaning a patient from tpn? | blood sugar |
| a normal blood sugar at 2 hour intervals will indicate what change to tpn | reduction of flow rate by half |
| daily labs are drawn for ____ and ____ imbalances on the pt receiving tpn | fluid and electrolyte imbalances |
| what is the risk if tpn is stopped abruptly? | the blood sugar will drop quickly |
| go over the complications of tpn therapy |
Created by:
Lori Dobrisky
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