Mnt 2 - Tpn

Front 1

Two types of TPN

Back 1

Central venous catheter
Peripherally inserted central catheter

Front 2

Central Parenteral Nutrition

Back 2

Short Term (PICC)
Long Term (Tunnel Catheters)
TOTAL
Provide 4000 kcal/day
Hypertonic

Front 3

Peripheral Parenteral Nutrition

Back 3

Short Term
-Cannot tolerate concentrated solutions
-Adjunct
Provide 1800 kcal/day
Isotonic

Front 4

Carbohydrates (PN)

Back 4

3.4 kcal/g
5%, 10%, 20%, 25%, 30%, 40%

25% (D25) = 25 g / 100 ml (250 g / 1000 ml)

Front 5

Carbohydrate goal (mg/kg/min)

Back 5

<5 mg/kg/min

Front 6

Protein (PN)

Back 6

3.5%, 5.5%, 8.5%, 10%, 15%
or
3.5%AA = 3.5g/100ml or 35g/1000 ml

Front 7

Lipid (PN)

Back 7

10% = 1.1 kcal/ml
20% = 2.0 kcal/ml
30% = 3.0 kcal/ml
ISOTONIC

Front 8

Lipid goal (PN)

Back 8

Do not exceed 2.5 g/kg/day

Front 9

Transition of Parenteral to Enteral

Back 9

2 to 3 days
Stop parenteral when enteral reaches 75%

Front 10

Transition of Parenteral to Oral

Back 10

Stop parentearl when oral reaches 75%

Front 11

Transition from Enteral to Oral

Back 11

Reduce enteral to only night to reestablish hunger cues

Front 12

Complications of PN

Back 12

Overfeeding, Underfeeding, electrolyte imbalance, hyperglycemia and refeeding syndrome.

Front 13

Complications of PN (gastrointestinal)

Back 13

cholestasis