Hi, I'm Cathy with Level Up RN. In this video, I'm going to continue my coverage of topics from the Level Up RN Nutrition flashcards. Specifically, I'll be talking about parenteral nutrition. And at the end of the video, I'm going to give you guys a quiz so you can test your understanding of some of the key points I'll be covering. So definitely stay tuned for that. And if you have our Flashcards, go ahead and pull out your Flashcard on parenteral nutrition, so you can follow along with me. And pay close attention to the bold red text on the back of the card because those are the things that you are likely to see show up on a nursing school exam.
Parenteral nutrition is where nutrients are delivered through an IV into the patient's vein. So it is not going through the patient's gastrointestinal tract. Total parenteral nutrition, or TPN, is typically administered through a PICC line or other central venous catheter. Indications for parenteral nutrition include malabsorption and malnutrition, and parenteral nutrition may also be necessary if the patient is in a hypermetabolic state or is going to be NPO for a long time. So I actually received TPN during my pregnancy because I had severe hyperemesis and was not able to get enough nutrients in on my own. So every day, I got a bag of 1,500 calories and a number of nutrients infused through my central venous catheter. Nursing care of TPN is heavily emphasized in nursing school, and it's important to know for your nursing practice as well. So let's go over some key points.
So first of all, when you receive your patient's bag of TPN from the pharmacy, you need to carefully compare the list of ingredients on the label of the bag with the provider's orders to make sure they match. And in many facilities, you will also need to get a second nurse to perform that check as well. When administering TPN, you need to use IV tubing with a filter. And the tubing and bag need to be changed every 24 hours. And as a reminder, we would never administer other fluids or medications through the TPN line. That line is just for TPN. And then when your patient is receiving TPN, you'll want to closely monitor their intake and output, daily weight, electrolyte levels, and blood glucose levels as well. If you need to increase or decrease your patient's TPN flow rate, you want to do so gradually in order to prevent hyperglycemia or hypoglycemia. And then if your patient is due for their next bag of TPN, and it has not arrived from the pharmacy yet, then you'll want to administer 10-to-20 percent dextrose in water until it arrives. If you don't do this and the patient's bag runs out, then their blood glucose levels are going to plummet, and we do not want that to happen. This is really important and something you will definitely get tested on in nursing school. So definitely be ready for that question.
All right. It's quiz time, and I've got three questions for you. Question number one. How often should the TPN tubing and bag be changed?
The answer is every 24 hours.
Question number two. Only 0.9% sodium chloride should be administered in the same line as TPN. True or false?
The answer is false. No other fluids or medications should be administered through the TPN line.
Question number three. If your patient is due for their next bag of TPN, and it has not arrived from the pharmacy, what should you do?
The answer is, you should administer 10-to-20 percent dextrose in water until the bag arrives. All right. That's it for this video. I hope it was helpful. Thank you so much for watching, and good luck with studying.
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