Nutritional Support

2 nurse check

what needs to be done if there is insulin in TPN bags

how often to change bags and tubing and filters of TPN

q24h

4-6 hours

how often to check blood sugar if giving TPN

• check if central line was dislodged

• hang a D10 bag until new TPN bag is ready

what to do if TPN therapy is interrupted

wean!

what to do when it’s time for a pt to stop receiving TPN

• soybean oil

• fish oil

• eggs

be alert for allergies to what when it comes to lipid bags for TPN

infusion pump (not IV pump)

what to use to administer continuous enteral feedings

• Infusion pump

• gravity (homecare)

what to use to administer intermittent enteral feedings

before and after medications and bolus feedings

when to give a “water flush” with enteral feedings

aspiration

the most serious consideration with EN

yes…unless contraindicated (ex. if they are a serious aspiration risk - airway trumps lytes)

do you return residual contents?

30 mL

how much water to flush with in between each enteral medication

diarrhea

what is the most common adverse of EN

refeeding syndrome

when nutrition is started too quickly in severely malnourished pts

• nutrition support is started slowly

• labs (especially lytes) are monitored frequently and replaced as needed

how to prevent refeeding syndrome