Total Parenteral Nutrition TPN-IV Quiz

Dextrose is the most common carbohydrate used for Total Parenteral Nutrition (TPN) because it is easily absorbed by the body and provides a quick source of energy. It is a simple sugar that can be metabolized by all cells in the body and is commonly used in medical settings to provide nutrition to patients who are unable to eat or digest food orally. Fructose, invert sugar, and lactose are not as commonly used in TPN as dextrose.

Total parenteral nutrition (TPN) is a method of providing nutrients directly into the bloodstream when a person is unable to eat or absorb nutrients through the digestive system. TPN solutions typically contain electrolytes, trace elements, and vitamins. Electrolytes are essential for maintaining proper fluid balance and nerve function in the body. Trace elements are minerals that are required in small amounts for various physiological functions. Vitamins are organic compounds that are necessary for normal cell function, growth, and development. Therefore, adding electrolytes, trace elements, and vitamins to TPN solutions ensures that the patient receives the necessary nutrients to support their bodily functions.

In the case of a hyperglycemic, hyperosmolar, nonketotic coma secondary to TPN (total parenteral nutrition), the administration of insulin is necessary to reverse the condition. Insulin helps to lower blood glucose levels and promote the uptake of glucose by cells, thus improving the hyperglycemia. It also helps to prevent the production of ketones and corrects the imbalance in electrolytes caused by the hyperosmolarity. Anticoagulants, histamine blockers, and sodium lactate are not directly involved in the treatment of this condition, making insulin the correct answer.

Lipids are indicated to treat essential fatty acid deficiency because they are a major source of essential fatty acids. Essential fatty acids are necessary for various physiological processes in the body, including the synthesis of hormones and cell membranes. Lipids, such as omega-3 and omega-6 fatty acids, are rich sources of these essential fatty acids. Therefore, supplementing with lipids can help correct the deficiency and ensure the proper functioning of the body.

The source of protein used in TPN (Total Parenteral Nutrition) is free amino acids. TPN is a method of delivering nutrients directly into the bloodstream when a person is unable to consume food orally. Free amino acids are the building blocks of protein and can be easily absorbed by the body. By providing free amino acids, TPN ensures that the patient receives the necessary protein for their nutritional needs. Alpha globulins, casein amino acids, and immunoglobulins are not typically used as protein sources in TPN.

The administration set used for the infusion of TPN solutions should be changed every 24 hours. This is necessary to prevent the growth of bacteria and ensure the safety and effectiveness of the TPN solution. Over time, the administration set can become contaminated, leading to potential infection in the patient. Therefore, changing the administration set regularly helps maintain the integrity of the TPN solution and reduces the risk of complications.

Dry-scaling skin, thinning hair, thrombocytopenia, and liver function abnormalities are clinical manifestations of essential fatty acid deficiency. Essential fatty acids are important for the health of the skin, hair, and liver. When there is a deficiency of these fatty acids, it can lead to dry-scaling skin, thinning hair, thrombocytopenia (low platelet count), and liver function abnormalities. Therefore, essential fatty acid deficiency is the most likely condition that can explain these clinical manifestations.

TPN, or total parenteral nutrition, is a method of providing nutrients directly into the bloodstream when a person is unable to consume food orally. The purpose of TPN is to support the body's nutritional needs and promote anabolism, which is the process of building and repairing tissues. By providing essential nutrients such as carbohydrates, proteins, fats, vitamins, and minerals, TPN helps to maintain or restore the body's nutritional status and support growth and healing. Therefore, the correct answer is "achieve anabolism."

A filter with a porosity rating of 1.2u is appropriate for use with three-in-one nutrient solutions. This means that the filter has a pore size of 1.2 micrometers, which is small enough to effectively filter out any contaminants or particles that may be present in the nutrient solution. Using a filter with a smaller pore size ensures that the nutrient solution remains clean and free from any unwanted substances, allowing for optimal growth and health of plants or organisms that rely on the solution for nutrients.

Total Parenteral Nutrition (TPN) is used when patients cannot meet nutritional needs through the gastrointestinal tract. Common indicators include hypermetabolic states (e.g., severe burns, trauma, or sepsis), where energy demands are significantly increased. Malabsorption of enteral therapy occurs in conditions like short bowel syndrome or severe Crohn’s disease, preventing adequate nutrient absorption. Prolonged ileus, a condition where intestinal motility is impaired for an extended period, also necessitates TPN as the patient cannot tolerate oral or enteral nutrition, requiring intravenous nutritional support for sustenance.

Under a laminar flow hood in the pharmacy is the appropriate area for preparing TPN solutions because laminar flow hoods provide a sterile environment by filtering the air and removing contaminants. This is crucial for the preparation of TPN solutions, which require strict aseptic techniques to prevent contamination. The pharmacy is also equipped with the necessary equipment and supplies to accurately measure and mix the components of TPN solutions. Additionally, preparing TPN solutions in a controlled environment like the pharmacy allows for proper monitoring and quality control measures to ensure the safety and efficacy of the solutions.

The correct answer is glucose intolerance, electrolyte imbalances, and essential fatty acid deficiency. Total parenteral nutrition (TPN) is a method of providing nutrition through intravenous feeding. Glucose intolerance can occur as a result of excessive glucose infusion, leading to hyperglycemia. Electrolyte imbalances can occur due to the imbalance in electrolytes provided in the TPN solution or due to fluid shifts. Essential fatty acid deficiency can occur if the TPN solution does not contain an adequate amount of essential fatty acids, which are necessary for normal physiological functions. These potential complications highlight the importance of carefully monitoring and adjusting TPN therapy to prevent adverse metabolic effects.

The correct answer is 12-18 hours. This is the typical timeframe for the delivery of cyclic TPN therapy. Cyclic TPN therapy involves providing nutrients intravenously over a specific period of time, usually during the night while the patient is asleep. This allows the patient to have more freedom during the day and reduces the risk of complications associated with long-term TPN use. The 12-18 hour timeframe ensures that the patient receives adequate nutrition while still allowing for periods of fasting and normal eating during the day.

Peripheral parenteral nutrition (PPN) is a method of providing nutrition to patients who are unable to consume adequate nutrients orally or through enteral means. PPN is typically used for short-term therapies, usually lasting 6 to 12 weeks. The statement that crystalline amino acids used in PPN are within the 2-5% range is accurate. Crystalline amino acids are an essential component of PPN solutions and are typically formulated at concentrations within this range to meet the patient's nutritional needs. The standard dextrose concentration in PPN solutions is usually 20%, but this statement is not accurate in reflecting principles of PPN.

Using non-PVC tubing is a nursing consideration specific to the intravenous administration of lipids because lipids can interact with PVC tubing, causing leaching of plasticizers into the solution. This can lead to the formation of particles and emboli, which can be harmful to the patient if infused. Therefore, using non-PVC tubing is important to ensure the integrity and safety of the lipid infusion.