Total Parenteral Nutrition Indications Nursing Care & Complications

Total parenteral nutrition is a lifesaver Procedure  for patients who cannot get their nitration through eating

Everyone needs calories and protein, in addition to other substances, to stay healthy, TPN is a complete form of nutrition and may include a combination of sugar and carbohydrates (for energy)

Proteins (for muscle strength and Wound healing), lipids (fat) electrolytes and trace elements.

A patient’s prescription may contain all or some of the substances, depending on the condition.

TPN is administered through an intravenous infusion, usually using a central line.

A central line is a special, long –lasting IV line, surgically implanted in the chest, which goes through a vein directly into the heart.

Benefits of Total Parenteral Nutrition Support,

Preservation of Client Nutritional Status,
To Prevent malnutrition and Its Complications,
To meet post operative Nutritional Needs and complications,
How much TPN Volume to give,

Who requires Total Parental Nutrition Support ?

Critical Illness,
Who cannot eat > 5 days,

Client  at risk for malnutrition,

Client is already with Malnutrition or Unable to take from mouth,

Impaired bowel function,
Need for prolonged bowel rest,

How can diagnose Mall nutrition,

History Collection,
Anthropocentric measurements,
Physical Examination,
Laboratory Investigations,

Nursing Assessment for total parenteral Nutrition,

Anthropocentric Measurements,
BMI Calculation,
Weight for Height calculation,
Height Index,
Mid arm Muscle circumference,

How much TPN Volume to give  ?

By Body Weight, 30 – 50 ml for kg/day,
Normal Maintenance Requirements,

Common Indications  for TPN Administration

  1. GI tract cancer.
  2. Crohn’s disease.
  3. Pancreatitis.
  4. Absorption syndrome.
  5. Inflammatory- bowel disease.
  6. Ulcerative colitis
  7. Short-bowel syndrome.
  8. Cystic fibrosis
  9. Massive bowel resection.
  10. Persistent intestinal fistulae.
  11. Trauma –related GI complications.
  12. Conditions that severely limit intestinal function,

 

Complications related to Total Parenteral Nutrition(TPN),Infections,

  • Mechanical Complications,
  • Metabolic Complications,
  • Infectious complications,

Infectious complications,

Catheter contamination,
Improper insertion technique,
Catheter contamination,
Insertion site contamination,

Mechanical complication:

Bleeding,

Catheter Malplacement,

Catheter occlusion,
Catheter embolism,
Air Embolism,
Pneumothorax,
Venous thrombosis,

Metabolic complications,

Hypoglycemia,
Hyperglycemia,
Hyperlipidemia,
Electrolyte abnormalities,
Acid – base disorders,
Inadequate administration.

 

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