Gastrointestinal System Disorders Q 143

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Stephanie, a 28 y.o. accident victim, requires TPN. The rationale for TPN is to provide:

  

    A. Necessary fluids and electrolytes to the body.

    B. Complete nutrition by the I.V. route.

    C. Tube feedings for nutritional supplementation.

    D. Dietary supplementation with liquid protein given between meals.

    

    

Correct Answer: B. Complete nutrition by the I.V. route.

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TPN is given I.V. to provide all the nutrients your patient needs. Parenteral nutrition is the intravenous administration of nutrition outside of the gastrointestinal tract. Total parenteral nutrition (TPN) is when the IV administered nutrition is the only source of nutrition the patient is receiving. Total parenteral nutrition is indicated when there is an inadequate gastrointestinal function and contraindications to enteral nutrition.

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Option A: Enteral diet intake is preferred over parenteral as it is inexpensive and associated with fewer complications such as infection and blood clots but requires a functional GI system. TPN is a mixture of separate components which contain lipid emulsions, dextrose, amino acids, vitamins, electrolytes, minerals, and trace elements. TPN composition should be adjusted to fulfill individual patients’ needs. The main three macronutrients are lipids emulsions, proteins, and dextrose.

Option C: TPN isn’t tube feeding. Total parenteral nutrition administration is through a central venous catheter. A central venous catheter is an access device that terminates in the superior vena cava or the right atrium and is used to administer nutrition, medication, chemotherapy, etc. Establishing this access could be through a peripherally inserted central catheter (PICC), central venous catheter, or an implanted port.

Option D: TPN is not a liquid dietary supplement. A 3-in-1 solution and intravenous lipid emulsions) mixed with electrolytes, trace elements, vitamins, and water. Parenteral solution with only dextrose and amino acids with a separate intravenous lipid emulsions infusion, the 2-in-1 solution has also been previously used. Research has shown TNA to be the standard of care for adult TPN.

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