Parenteral Nutrition Monitoring
Key Points
- Parenteral nutrition is used when the GI tract cannot safely absorb nutrients.
- PN requires strict infusion accuracy and line-care safety, often via central access.
- Monitoring focuses on infection risk, glycemic/metabolic trends, fluid status, and liver/renal tolerance.
Pathophysiology
Parenteral nutrition bypasses GI processing and delivers nutrients intravascularly. This supports nutrition in severe GI dysfunction but raises risk for catheter-related infection and metabolic complications if monitoring is inadequate.
Classification
- PPN: Shorter-term, lower osmolar formulations, usually via PICC or appropriate access.
- TPN: Full nutrition replacement, typically via central venous catheter.
- Infusion formats: Two-in-one and three-in-one admixtures based on facility protocol.
Nursing Assessment
- Assess central-line status, dressing integrity, and CLABSI risk cues.
- Assess blood glucose, electrolytes, and protein markers per monitoring schedule.
- Assess fluid-balance trend (edema, I/O, daily weights) and end-organ tolerance.
Nursing Interventions
- Use dedicated line and pump safeguards for PN infusion.
- Perform ordered lab surveillance and respond quickly to abnormal trends.
- Maintain sterile line-care technique and tubing-change schedule per policy.
- Coordinate with pharmacy/dietetics to adjust composition based on response.