Parental Nutrition

done up to lo2 need to do next lo but also need to add some more defintions so i understnad too

What is the correct definition of parenteral nutrition (PN)?

Refers to the provision of nutrients by the intravenous rout

When should parenteral nutrition be used?

Only to be used when it’s not possible to supply nutrition using the GI tract

What is the key principle guiding the use of enteral vs parenteral nutrition?

“If the gut works, use it”

Which of the following is NOT an indication for PN?

Functional GI tract

Which conditions is most strongly associated with intestinal failure requiring PN?

Short Bowel Syndrome, Crohn's disease, or bowel resection.

Which of the following is not a clinical use of PN?

Weight maintenance in healthy individuals

Which of the following is not a clinical use of PN?

Treating dehydration and appetite

What is a high-output fistula?

Abnormal bowel connections causing massive nutrient loss.

Which patient group may require PN due to hypercatabolism?

 Sepsis, trauma

What does Total Parenteral Nutrition (TPN) provide?

All macro- and micronutrients intravenously

Which statement about PN supplementation is correct?

Some patients treated with PN can absorb some fluid and nutrition taken orally, and in these patients, PN is a supplement to their oral intake.

What defines intestinal failure?

Reduced gut function requiring IV supplementation

What defines intestinal failure?

Reduction of gut function below the minimum needed for macronutrient and water/electrolyte absorption, requiring intravenous supplementation to maintain health or growth.

Which type of intestinal failure is short-term and self-limiting?

Type I

Which type of intestinal failure requires PN for months or years?

Type III

Which type of intestinal failure requires PN for weeks or months?

Type II

Which type of intestinal failure definition is related to Type I?

an acute, short-term and usually self-limiting condition eg post-operative ileus.

Which type of intestinal failure definition is related to Type III?

a chronic condition, in metabolically stable patients, who require PN over months or years. It may be reversible or irreversible.

Which type of intestinal failure definition is related to Type II?

a prolonged acute condition, often in metabolically unstable patients, requiring complex multi-disciplinary care and PN over periods of weeks or months.

Which statement about PN bioavailability is correct?

PN has 100% bioavailability

What is the most significant overall risk associated with PN?

Constipation

Which complication is most commonly associated with PN line insertion?

Pneumothorax- incidence of 0.5 – 1%

What is required after central line insertion to confirm correct (a Misplacement) placement after subclavian and jugular CVC insertion?

Chest X-ray

What is the first step in suspected line sepsis?

Blood cultures

When should a PN line be removed in sepsis?

If infection is confirmed

What is the main cause of thrombophlebitis in PN?

High osmolarity solutions

A serious consequence of PN-related thrombosis is:

SVC occlusion

What is the standard treatment for PN-related thrombosis and phlebitis?

Anticoagulation

How can line blockage be prevented?

Frequent line flushing all the lumens

What is the hallmark electrolyte abnormality in refeeding syndrome?

Hypophosphataemia

Which not a symptom is associated with refeeding syndrome?

Constipation

How is refeeding syndrome best prevented?

Starting slowly (<50% requirements) within the first 24 hours

What is the most common cause of hyperglycaemia in PN?

Excessive carbohydrate (CHO) infusion

How is PN-related hyperglycaemia managed?

Reduce CHO if exceeding 5 mg/kg/min.Add insulin (can be in or out of the bag).

What is a key cause of hypertriglyceridaemia in PN?

Excess lipid infusion

What is a chronic complication of long-term PN?

Intestinal Failure-Associated Liver Disease (IFALD)

Which condition is linked to PN-related gallbladder complications?

gallbladder stasis (a lack of gallbladder contraction and emptying)

What type of bone condition can occur with long-term PN?

Osteoporosis

Which of the following is not a high-risk sepsis indicator in PN patients?

Respiratory rate (BPM): >20 OR new need for >50% 22-24 to maintain saturation >88%

Which of the following is not a high-risk sepsis indicator in PN patients?

Heart rate (BPM): > 80 bpm

A patient on PN has not passed urine for 18 hours and has cyanosis. What does this suggest?

High-risk sepsis

Which of the following indicates moderate-to-high sepsis risk?

Temperature <36°C

Which of the following is not a moderate-risk sepsis indicator in PN patients?

Systolic BP (mmHg):<90 mmHg

Which of the following is not a moderate-risk sepsis indicator in PN patients?

Heart rate (BPM):>130 bpm

Which factor increases the risk of PN-related sepsis?

Using a number of lumens and manipulations

What is not true about how Total Peripheral Parenteral Nutrition (TPN) is given?

Peripheral veins (such as those in the hand or forearm

Access Routes CVC (central lines) has/is

Long-term, high concentration

Where is Total Parenteral Nutrition (TPN) typically delivered?

Superior vena cava/right atrium.

What is the bioavailability of PN?

100%

Why does PN bypass first-pass metabolism?

It enters systemic circulation directly

What is the first 4 things on how to What are the first 4 things on how to calculate Parenteral Nutrition Formulations?

1) Calculate energy requirements (REE &TTE). 2) Calculate protein requirements. 3) Calculate nitrogen requirements. 4)Determine non-protein energy (NPE).