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NSC 325 last exam PN with complete solutions.
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NSC 325 last exam PN with completesolutions
parenteral /nutrition /- /correct /answer-delivery /of /nutrient /intravenously /via /bloodstream
-central /parenteral /nutrition: /often /called /total /PN; /delivered /into /central /vein
-peripheral /PN: /delivered /into /a /smaller /or /peripheral /vein
common /indications /for /PN /- /correct /answer--patient /has /failed /EN /w/ /appropriate /tube /placement
(severe /acute /pancreatitis)
-severe /short /bowel /syndrome
-mesenteric /ischemia
-paralytic /ileus
-small /bowel /obstruction
-GI /fistula
-malnourish /or /@ /high /risk /ICU /patient /when /EN /not /feasible /or /adequate
-consider /supplemental /PN /after /7-10 /days /when /EN /not /feasible /or /inadequate
-do /not /start /for /7-10 /days /in /healthy /patients
Contraindications /for /PN /(releases /to /not /administer) /- /correct /answer--
functional /& /accessible /GI /tract
-patient /is /taking /oral /diet
-prognosis /doesnt /warrant /aggressive /nutrition /support /(terminally /ill)
-risk /exceeds /benefit
-patient /expected /to /meed /needs /w/in /14 /days
Catheter /lumens /- /correct /answer-single, /double /or /multilumen
-need /sterile /lumen /for /PN /to /decrease /infections
,Peripheral /PN /- /correct /answer-1) /need /more /fluid /to /infuse /so /the /vein /"will /tolerate"
2) /also /usually /reduce /on /the /dextose, /AA /& /additives /leading /to /inadequate /nutrition /support
3)large /nutrition /or /electrolyte /needs /(potassium /is /a /strong /vascular /irritant)
4) /contraindications
-fluid /restriction
-need /for /prolonged /PN />2wks
-renal /or /liver /compromise
Parenteral /Nutrition /formulations /- /correct /answer--
components /are /in /elemental /or /"pre /digested" /form
1) /solution /contains:
-proteins /as /amino /acids
-energy /sources: /CHO /as /dextrose, /fat /as /lipid /emulsion
-electrolytes, /vit, /minerals
-other: /meds
PN /solutions /- /correct /answer-1) /Total /nutrient /admixture /(TNA) /or /3 /in /1
-dextrose, /amino /acid, /lipids, /additives /are /mixed /together /in /1 /container
-
lipid
/is /provided /as /part /of /the /PN /mixture /on /a /daily /basis /& /becomes /an /important /energy /substrate
2) /2 /in1 /solution: /dextrose, /amino /acids, /additives
-typically /compounded /in /1 /L /bags
-lipid /is /delivered /as /piggyback /daily /or /intermittently /as /a /source /of /EFA
TNA /or /3 /in /1 /advantages /- /correct /answer--decreased /nursing /time
-decreased /risk /of /tough /contamination
-decreased /pharmacy /prep /time
-cost /savings
-easier /administration /in /home /PN
, -better /fat /utilization /in /slow, /continuous /infusion /of /fat
-physiological /balance /of /macronutrients
Disadvantages /of /TNA /or /3 /in /1 /- /correct /answer--diminished /stability /& /compatibility
-IVFE /(IV /fat /emulsions) /limits /the /amount /of /nutrients /that /can /be /compounded
-limited /visual /inspection /of /TNA; /decreases /ability /to /detect /precipitates
Administration /of /PN /- /correct /answer-1) /continuous
-24 /hrs/day
-promote /best /tolerance
2) /cyclic /infusion
-8-16 /hrs/day
-usually /at /night
-ideal /for /long /term/home /TPN
-pump /ALWAYS /used
Macronutrients: /carbs /- /correct /answer-energy /source /as /monohydrous /dextrose
1) /properties
-nitrogen /sparing
-energy /source
-3.4 /kcal/g
-hypersmolar
2) /recommended /intake
-2-5 /mg/kg/min
-50-60% /of /total /kcal
3) /potentially /adverse /effects
-increased /minute /ventilation, /CO2 /production, /RQ, /O2 /consumption
-lipogenesis /& /liver /probs
-hyperglycemia
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