Wk. 4 - Administering Parenteral Nutrition Flashcards

What is the primary clinical indication for PN?

When the GI tract is nonfunctional or cannot absorb nutrients.

Name two GI disorders that may require PN.

Severe Crohn’s exacerbation, short bowel syndrome, radiation enteritis, ischemic bowel.

What surgical condition may necessitate PN?

Complicated GI surgery or prolonged postoperative ileus.

Why is PN preferred over enteral nutrition only when absolutely necessary?

PN carries higher risks and is used only when the gut “does not work.”

What acute inflammatory condition may require PN due to need for GI rest?

Severe pancreatitis.

Why is prolonged bowel obstruction an indication for PN?

It prevents use of the GI tract for nutrient absorption.

What carbohydrate source provides calories in PN?

Dextrose.

What macronutrient in PN provides protein?

Amino acid solution.

What solution provides fat in PN?

Intravenous lipid emulsion (soybean/safflower oil + egg phospholipids).

Name three electrolytes commonly added to PN.

Sodium, potassium, chloride, calcium, magnesium, phosphate, acetate.

What type of vitamins are added to PN?

Multivitamin infusion.

Which trace elements are commonly added to PN?

Zinc, copper, manganese, selenium, chromium.

Why are both micronutrients and macronutrients required in PN?

To provide complete nutrition when the GI tract is bypassed.

When must PN be administered via a central line?

When dextrose concentration is >15% or osmolality is high.

When is peripheral PN appropriate?

For short-term, low-calorie nutritional support.

What technique must be used for central line care with PN?

Strict aseptic technique to prevent CLABSI.

Why are IV in-line filters used for PN?

To remove particulate matter and prevent emboli.

How long can PN without lipids hang?

Up to 24 hours.

How long can IV lipid emulsions hang alone?

Up to 12 hours (24 hours if mixed in a 3-in-1 solution).

Why can’t medications be piggybacked into a PN line?

Risk of incompatibility and contamination.

What is the most common metabolic complication of PN?

Hyperglycemia.

What electrolyte abnormalities define refeeding syndrome?

Hypophosphatemia, hypokalemia, hypomagnesemia.

What complication may occur with long-term PN use?

PN-associated liver disease.

What are two central line–related complications of PN?

CLABSI and catheter thrombosis.

What is fat overload syndrome?

A reaction to lipid infusion causing N/V, fever, coagulopathy, respiratory distress, and liver dysfunction.

What life-threatening complication can occur with central line insertion or removal?

Air embolism.

How often should blood glucose be monitored initially for PN patients?

Every 6 hours.

Why should PN never be abruptly discontinued?

It may cause rebound hypoglycemia.

What is the nursing intervention if air embolism is suspected after central line removal?

Place patient in left side Trendelenburg, apply O₂, notify provider.

What baseline and ongoing assessments are important in PN patients?

Daily weights, I&O, electrolytes, triglycerides, liver/renal function, and central line site assessments.