Nurses Role in TPN Care_1

Nurses Role in TPN Care_1

1. Obtain Complete Physical Exam

   • Intervention: Use strict aseptic technique with IV tubing, dressing changes, and TPN solutions . Refrigerate solution until 30 minutes before using. ( Infusing site is high risk for developing infection)
     • Maintain accurate infusion rate changes gradually, ( Never discontinue TPN abruptly may cause hypoglycemia and sudden change in flow rate -can cause fluctuations in blood glucose levels

2. Obtain health history, allergies, drug history possible drug interactions

   • Intervention : Monitor Blood glucose, observe for signs of hyperglycemia and hypoglycemia, and administer insulin as directed. Blood glucose levels may be affected if TPN is turned off, if the rate is reduced or if excess levels of insulin are added to the solution

3. Assess for presence of history of deficits such as inadequate oral intake, GI disease, and increase metabolic need

   • Intervention: Monitor VS,observe for signs of infection (High Temp)

4. Obtain Lab studies:-Protein & Albumin, Creatinine/BUN, CBC Electrolytes, lipid profile, Serum Iron

   • Monitor: I&Os, daily weights,
   • Monitor for signs of fluid overload, (TPN is hypertonic solution and can create intravascular shifting of extracellular fluid

5. Goals, Client will : 1, Exhibit improvement or stabilization of nutritional status, 2. Be free of infection or injury related to TPN . 3. Demonstrate an understanding of the drugs actions by accurately describing drug side effects and precautions 4.Immediately report side effects such as symptoms of hypoglycemia or hyperglycemia, fever, chills cough, or malaise

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