Parenteral Nutrition Administration Flashcards

What is the maximum recommended rate for initiating total parenteral nutrition in an adult patient?

Answer: 25-50% of goal rate for the first 24 hours

TPN should be initiated at 25-50% of the goal rate and advanced gradually over 24-48 hours to prevent metabolic complications including refeeding syndrome.

Which filter size is required for 3-in-1 (total nutrient admixture) parenteral nutrition containing lipids?

Answer: 1.2-micron filter

A 1.2-micron filter is required for 3-in-1 TNA solutions because lipid emulsion particles (0.4-0.5 microns) cannot pass through a 0.22-micron filter.

A patient's TPN is abruptly discontinued. What is the immediate nursing concern?

Answer: Rebound hypoglycemia

Abrupt TPN discontinuation can cause rebound hypoglycemia because the pancreas continues producing elevated insulin levels in response to the sudden drop in glucose infusion.

What electrolyte must be closely monitored during the first 72 hours of TPN initiation in a malnourished patient?

Answer: Phosphorus

Phosphorus is the most critically affected electrolyte in refeeding syndrome, as insulin-driven cellular uptake can cause severe hypophosphatemia leading to respiratory and cardiac failure.

Why must parenteral nutrition solutions be administered through a dedicated lumen?

Answer: To prevent contamination, incompatibilities, and interruptions that affect glucose delivery

A dedicated lumen prevents microbial contamination from multiple access points, drug incompatibilities, and infusion interruptions that could cause blood glucose instability.

What is the maximum hang time for a lipid-containing parenteral nutrition solution?

Answer: 24 hours

Lipid-containing PN solutions (3-in-1 TNA) must be infused within 24 hours to minimize microbial growth risk in the lipid-rich medium.