Nurses Role in TPN

blinn.melissa
Mind Map by blinn.melissa, updated more than 1 year ago
blinn.melissa
Created by blinn.melissa about 5 years ago
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Mind Map on Nurses Role in TPN, created by blinn.melissa on 01/24/2015.

Resource summary

Nurses Role in TPN
1 assess
1.1 allergies, drug history, drug interactions
1.2 presence or history of nutritional deficits
1.3 physical exam
1.4 TPN solution is appropriate for patient age and organ function status
1.5 lab studies: protein/albumin, creatinine/BUN, CBC electrolytes, lipid profile, serum iron levels
2 goals
2.1 no adverse reaction to TPN
2.2 lab studies stay within normal ranges/improve
2.3 nutritional status improves
2.4 patient can state possible s/e and adverse reactions and will report immediately if any occur
2.5 patient will not develop an infection and will keep site clean
3 interventions
3.1 monitor vital signs
3.2 daily weights
3.3 monitor fluid I&O's continuously
3.4 monitor glucose levels q6h or as ordered
3.4.1 monitor for signs and symptoms of hyperglycemia and hypoglycemia
3.4.1.1 give insulin subq PRN
3.5 monitor lab studies
3.5.1 liver function tests, plasma proteins, prothombin time, plasma and urine osmoality; Ca, Mg and phosphate levels
3.5.2 CBC, electrolytes, BUN daily
3.6 keep site sterile and change dressing q48h
3.7 monitor for fluid overload
3.8 monitor for adverse reactions
3.8.1 dyspnea, nausea, headache, back pain, sweating, dizziness
4 patient teaching
4.1 s/s of infection: chills, fever, tenderness at infusion site
4.2 s/s of hyperglycemia: polydipsia, polyphagia, polyuria
4.3 s/s of hypoglycemia: nervousness, irritability, dizziness
4.4 importance of daily weights
4.5 monitor I&Os
4.6 report: increase in weight, decrease in urine output, shortness of breath, swelling, heart palpitations
4.7 never stop infusion abruptly unless HCP instructs to
5 evaluate
5.1 patient's nutritional status has improved
5.2 patient verbalizes importance of reporting side effects and adverse reactions immediately
5.3 patient doesn't acquire infection or adverse reaction related to TPN
6 MELISSA FERRELL 1/24/2015
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