Parenteral nutrition
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Questions and Answers

Which of the following is a recommended method for managing changes in GI flora?

  • Transfaunation (correct)
  • Do nothing
  • Use pre and pro-biotics
  • Increase enteral food intake

    • What are the potential complications of parenteral nutrition?

  • Catheter issues
  • Inadequate admixture
  • Metabolic abnormalities
  • All of the above (correct)

    • What happens when food is withheld?

  • Villi stunting
  • Decreased absorptive capacity
  • Gastric ulceration
  • All of the above (correct)

    • What is the purpose of gastric acid in the stomach?

    <p>To protect against bacteria caused gastric ulcers</p> Signup and view all the answers

    What is the recommended approach for weaning off parenteral nutrition?

    <p>Gradually decrease parenteral nutrition by 25% every 6 to 8 hours</p> Signup and view all the answers

    What is the most common complication of parenteral nutrition?

    <p>Metabolic abnormalities</p> Signup and view all the answers

    What is the recommended method for managing catheter issues in parenteral nutrition?

    <p>Proper compounding</p> Signup and view all the answers

    What is the purpose of pre-treating with glutamine before stopping parenteral feeding?

    <p>To prevent re-feeding syndrome</p> Signup and view all the answers

    What is the recommended approach for starting enteral food during parenteral nutrition?

    <p>Gradually increase enteral food intake</p> Signup and view all the answers

    Which route is parenteral nutrition administered through?

    <p>Intravenous route</p> Signup and view all the answers

    When is parenteral nutrition used?

    <p>When the enteral route is not feasible</p> Signup and view all the answers

    Why is it important to not delay starting parenteral nutrition if required?

    <p>The enteral route may not be any more appropriate tomorrow than it is today</p> Signup and view all the answers

    In which species is parenteral nutrition used more frequently?

    <p>Horses</p> Signup and view all the answers

    In equine neonates, why is enteral feeding contraindicated in septic patients?

    <p>It leads to fatal C. difficile enterocolitis</p> Signup and view all the answers

    What is a common complication seen in equine post-operative colics that makes enteral feeding challenging?

    <p>Nasogastric reflux</p> Signup and view all the answers

    Why is it important to start parenteral nutrition sooner in equine neonates with sepsis?

    <p>To prevent protein catabolism</p> Signup and view all the answers

    What is the ideal location for placing a cannula for parenteral nutrition administration?

    <p>Central vein</p> Signup and view all the answers

    Why is 24-hour nursing care necessary for patients receiving parenteral nutrition?

    <p>To monitor blood glucose levels</p> Signup and view all the answers

    What are the components of TPN (total parenteral nutrition)?

    <p>Glucose, protein, and lipids</p> Signup and view all the answers

    Which type of catheter should NOT be used for anything else other than parenteral nutrition?

    <p>Peripheral venous catheter</p> Signup and view all the answers

    Why should parenteral nutrition solutions be administered through a central line rather than a peripheral vein?

    <p>To decrease the risk of thrombophlebitis</p> Signup and view all the answers

    What is the recommended frequency for dressing and examining long-stay catheters used for parenteral nutrition?

    <p>Twice a day</p> Signup and view all the answers

    What is the best way to deliver parenteral nutrition?

    <p>As a continuous rate infusion</p> Signup and view all the answers

    Which of the following measures should be regularly monitored in patients receiving parenteral nutrition?

    <p>Blood glucose, electrolytes, BUN, and albumin</p> Signup and view all the answers

    What is the main purpose of parenteral nutrition formulations?

    <p>To prevent protein catabolic state and promote healing</p> Signup and view all the answers

    What is the recommended duration of IV parentral nutrition for maximum use?

    <p>1-2 weeks</p> Signup and view all the answers

    Which of the following complications can occur with parenteral nutrition?

    <p>Hyperglycaemia, lipaemia, azotaemia, and hyperammonaemia</p> Signup and view all the answers

    Why is it important to calculate the energy and protein requirements for patients receiving parenteral nutrition?

    <p>To prevent complications such as fatty infiltration of the liver</p> Signup and view all the answers

    What are the technical requirements for administering parenteral nutrition?

    <p>Ideally a canula in a central vein, aseptic vascular access, 24 hour nursing care, point-of-care glucose monitoring, and formulation of PPN or TPN.</p> Signup and view all the answers

    Why is enteral feeding contraindicated in septic equine neonates?

    <p>Enteral feeding would lead to fatal C. difficile enterocolitis due to the inability of the GI tract to cope with feeding, leading to clostridial bacterium overgrowth.</p> Signup and view all the answers

    What is the difference between PPN and TPN?

    <p>PPN stands for peripheral parenteral nutrition and contains glucose and protein, while TPN stands for total parenteral nutrition and contains glucose, protein, and lipids.</p> Signup and view all the answers

    What are three options for managing changes in GI flora?

    <p>Do nothing, use pre and pro-biotics, transfaunation</p> Signup and view all the answers

    What are some complications of parenteral nutrition?

    <p>Catheter issues, microbial contamination, precipitation, drug-nutrient interactions, metabolic issues, re-feeding syndrome, electrolyte abnormalities</p> Signup and view all the answers

    What is the recommended approach for weaning off parenteral nutrition?

    <p>Gradually decrease Parenteral nutrition by 25% every 6 to 8 hours</p> Signup and view all the answers

    What are the potential consequences of withholding food?

    <p>GI changes such as villi stunting and decreased absorptive capacity, gastric ulceration, potential ulcers in glandular region, controversy regarding prophylaxis and treatment</p> Signup and view all the answers

    What are the risks associated with administering parenteral nutrition through a peripheral vein?

    <p>Solutions are hyper-osmolar and can be irritant to the veins, increasing the risk of thrombophlebitis. Peripheral administration is limited by tolerance of fluid volumes.</p> Signup and view all the answers

    What complications can occur with hyperglycemia in patients receiving parenteral nutrition?

    <p>Hyperglycemia can occur in patients with diabetes mellitus or hyperadrenocorticism. It can also lead to lipaemia, azotaemia, hyperammonaemia, and refeeding syndrome.</p> Signup and view all the answers

    What is the recommended approach for calculating the energy and protein requirements in patients receiving parenteral nutrition?

    <p>Energy should be aimed for resting energy requirement (RER) or less. Protein should be provided at 4-6g/100KCal for dogs and 6g/100KCal for cats.</p> Signup and view all the answers

    Study Notes

    Managing Changes in GI Flora

    • Probiotics, prebiotics, and symbiotics are recommended methods for managing changes in GI flora

    Complications of Parenteral Nutrition

    • Infections, hyperglycemia, and electrolyte imbalances are potential complications of parenteral nutrition
    • The most common complication of parenteral nutrition is catheter-related infection

    Purpose of Gastric Acid

    • Gastric acid helps to break down food in the stomach and prevent bacterial overgrowth

    Weaning Off Parenteral Nutrition

    • Gradually decreasing the rate of parenteral nutrition while increasing enteral feeding is the recommended approach for weaning off parenteral nutrition

    Catheter Issues

    • Flushing the catheter with heparinized saline and replacing the catheter are recommended methods for managing catheter issues in parenteral nutrition

    Pre-treating with Glutamine

    • Pre-treating with glutamine before stopping parenteral feeding helps to reduce bacterial overgrowth and maintain gut health

    Starting Enteral Food

    • Starting enteral food at a low rate and gradually increasing the rate is the recommended approach for starting enteral food during parenteral nutrition

    Administration of Parenteral Nutrition

    • Parenteral nutrition is administered through a central line, typically a jugular or subclavian vein

    Indications for Parenteral Nutrition

    • Parenteral nutrition is used when the gut is not functioning or when a patient is unable to tolerate enteral feeding, such as in cases of sepsis, malabsorption, or severe gastrointestinal disease

    Importance of Timely Parenteral Nutrition

    • Delaying the start of parenteral nutrition can lead to malnutrition, compromised immune function, and increased morbidity and mortality

    Species and Parenteral Nutrition

    • Parenteral nutrition is used more frequently in equine species

    Contraindications for Enteral Feeding

    • In equine neonates, enteral feeding is contraindicated in septic patients due to the risk of bowel perforation and peritonitis

    Complications of Enteral Feeding

    • Post-operative colics and diarrhea are common complications seen in equine post-operative colics that make enteral feeding challenging

    Importance of Early Parenteral Nutrition in Equine Neonates

    • Early initiation of parenteral nutrition is important in equine neonates with sepsis to prevent malnutrition and support immune function

    Ideal Location for Cannula Placement

    • The ideal location for placing a cannula for parenteral nutrition administration is the jugular or subclavian vein

    Nursing Care for Patients Receiving Parenteral Nutrition

    • 24-hour nursing care is necessary for patients receiving parenteral nutrition to monitor for complications and ensure timely intervention

    Components of TPN

    • TPN (total parenteral nutrition) consists of macronutrients (carbohydrates, proteins, and fats), micronutrients (vitamins and minerals), and electrolytes

    Catheter Selection

    • A dedicated catheter should be used for parenteral nutrition, and it should not be used for anything else

    Importance of Central Line Administration

    • Parenteral nutrition solutions should be administered through a central line rather than a peripheral vein to reduce the risk of complications such as phlebitis and infection

    Catheter Maintenance

    • Dressing and examining long-stay catheters used for parenteral nutrition should be done at a recommended frequency to reduce the risk of infection

    Best Way to Deliver Parenteral Nutrition

    • The best way to deliver parenteral nutrition is through a continuous infusion, with the rate adjusted according to the patient's needs

    Monitoring Parameters

    • Patients receiving parenteral nutrition should be regularly monitored for blood glucose, electrolyte levels, and liver function

    Purpose of Parenteral Nutrition Formulations

    • The main purpose of parenteral nutrition formulations is to provide essential nutrients and energy to support the patient's recovery
    • The recommended duration of IV parenteral nutrition is typically 2-3 weeks, depending on the patient's condition and response to treatment

    Complications of Parenteral Nutrition

    • Complications of parenteral nutrition include metabolic bone disease, electrolyte imbalances, and hyperglycemia

    Importance of Calculating Energy and Protein Requirements

    • Calculating the energy and protein requirements for patients receiving parenteral nutrition is important to ensure adequate nutrition and prevent complications

    Technical Requirements for Administering Parenteral Nutrition

    • The technical requirements for administering parenteral nutrition include a dedicated infusion pump, a central line, and aseptic technique

    Contraindications for Enteral Feeding

    • Enteral feeding is contraindicated in septic equine neonates due to the risk of bowel perforation and peritonitis

    Difference between PPN and TPN

    • PPN (peripheral parenteral nutrition) is a lower-calorie, lower-protein formulation, whereas TPN (total parenteral nutrition) is a higher-calorie, higher-protein formulation

    Risks of Withholding Food

    • Withholding food can lead to malnutrition, compromised immune function, and increased morbidity and mortality

    Risks of Peripheral Vein Administration

    • Administering parenteral nutrition through a peripheral vein increases the risk of phlebitis, infection, and thrombosis

    Complications of Hyperglycemia

    • Hyperglycemia in patients receiving parenteral nutrition can lead to complications such as osmotic diuresis, dehydration, and electrolyte imbalances

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    Description

    Test your knowledge on parenteral nutrition, a method of administering nutrition through IV or IO routes for small patients and neonates when the enteral route is not feasible. Learn about the indications for parenteral nutrition and why it is crucial for life-sustaining support. Don't delay starting if required, as the enteral route may not become more appropriate in the future. Find out more about this frequently used method of nutrition administration in this quiz.

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