Assess Parenteral Nutrition Therapy
1. Perform hand hygiene.
2. Identify the patient using two separate identifiers.
3. Close door or bed curtains and explain the procedure to
Monitoring Total Parenteral Nutrition Therapy
4. Schedule and assist patient with chest x-ray after central
5. Confirm correct solution against physician’s order. Check
solution’s expiration date. Assess patient allergies. Set the
EID for the proper infusion rate. (Note: Solutions with
more than 10% dextrose must be infused directly into a
central catheter to rapidly dilute the solution and prevent
thrombophlebitis. Constant flow rate helps prevent hyperg-
lycemia and electrolyte imbalances.)
6. Inspect tubing and catheter connection for leaks or kinks.
Tape all connections. Change tubing every 24 hours
according to agency policy.
7. Inspect insertion site for infiltration, thrombophlebitis, or
drainage. If present, notify physician. The physician may
order removal of the catheter and culture of the catheter tip.
8. Monitor vital signs, including temperature, every 4 hours.
9. Use the TPN line only for administration of TPN and lip-
ids. Do not use the line for any other reason.
10. Monitor patient’s blood glucose as ordered (usually every
6 to 12 hours). Notify physician if abnormal.
11. Monitor laboratory tests of electrolytes, blood urea nitro-
gen (BUN), and glucose, as ordered, and report abnormal
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