e | 15 Indications for Parenteral Nutrition read chart pg 1228 └ └ Intake is insufficient to maintain anabolic state. └ Ability to ingest food orally or by tube is impaired. └ Patient is not interested or is unwilling to ingest adequate nutrients. └ The underlying medical condition precludes oral or tube feeding. └ Preoperative and postoperative nutritional needs are prolonged. Nursing Process: The Care of the Patient Receiving Parenteral Nutrition — Assessment read home care pg 1232-33 └ Assist in identifying patients who are candidates for PN └ Nutrition status └ Hydration status └ Electrolytes └ Signs and symptoms of hypoglycemia or hyperglycemia Monitor blood glucose └ Assess for potential complications VS, including temperature every 4 hours or by protocol └ Put D10 if you don’t have the nutrition liquid Nursing Process: The Care of the Patient Receiving Parenteral Nutrition — Diagnoses └ Imbalanced nutrition └ Risk for infection └ Risk for excess or deficient fluid └ Risk for immobility └ Risk of ineffective therapeutic regimen Nursing Process: The Care of the Patient Receiving Parenteral Nutrition — Planning └ Major goals may include attaining an optimal level of nutrition, absence of infection, adequate fluid volume, optimal level of activity, knowledge of self-care, and absence of complications. Try to return pt to normal life Collaborative Problems and Potential Complications read chart page 1231 └ Pneumothorax While putting in the line └ Clotted or displaced catheter └ Sepsis Tip goes to lab when it comes out └ Hyperglycemia └ Rebound hypoglycemia └ Fluid overload Respitory distress Prevention of Infection Aseptic technic; mask steril gloves └ Appropriate catheter and IV site care └ Strict sterile technique for dressing changes └ Wear mask when changing the dressing
P a g e | 16 └ Assess insertion site Clean, dry, no redness, └ Assess for indicators of infection └ Proper IV and tubing care Maintaining Fluid Balance └ Use infusion pump. Flow rate should not be increased or decreased rapidly. If fluid runs out, hang 10% dextrose solution. └ Monitor indicators of fluid balance and electrolyte levels. └ I&O └ Weights └ Monitor blood glucose levels. Patient Education └ Goals and purpose └ Components of PN └ Emergency contact numbers └ Demonstrate use of equipment and how to handle and hang the IV └ Demonstrate dressing changes └ Demonstrate how to flush or heparinize the catheter └ Potential complications and actions TERMS TO KNOW AND NOT CONFUSE └ Parenteral nutrition is a method of supplying nutrients to the body by the intravenous route.
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