Parenteral Nutrition Administration Flashcards
6 cards from real CRNI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Parenteral Nutrition Administration flashcards as text
What is the clinical significance of lipid emulsion cracking in a TNA solution?
Answer: It represents irreversible destabilization with visible oil droplets that can cause fat embolism
Cracking indicates irreversible lipid emulsion destabilization with coalescence of oil droplets that can cause fatal fat embolism if infused.
Which trace element is MOST important to supplement in long-term parenteral nutrition to prevent cardiomyopathy?
Answer: Selenium
Selenium deficiency in long-term PN patients can cause Keshan-type cardiomyopathy, a potentially fatal condition preventable with adequate supplementation.
A patient on home PN reports cloudy urine and elevated blood glucose despite stable TPN formula. What should the CRNI assess?
Answer: Possible catheter-related infection causing hyperglycemia as an early sign
New-onset hyperglycemia in a patient on stable PN is a common early indicator of infection, particularly catheter-related bloodstream infection.
What is the recommended catheter tip position for administering parenteral nutrition?
Answer: Lower third of the SVC at the caval-atrial junction
The ideal catheter tip position for PN administration is the lower third of the SVC at the caval-atrial junction, where high blood flow provides optimal dilution of the hyperosmolar solution.
What is the appropriate management when a patient on cyclic PN (12-hour nighttime infusion) reports morning headaches and diaphoresis?
Answer: Evaluate for rebound hypoglycemia at the end of the cycle and implement a taper-down protocol
Morning headaches and diaphoresis at the end of cyclic PN suggest rebound hypoglycemia, managed by tapering the infusion rate during the last 1-2 hours.
Which complication of parenteral nutrition is indicated by elevated liver enzymes and direct bilirubin?
Answer: Parenteral nutrition-associated liver disease (PNALD)
PNALD manifests as cholestasis with elevated liver enzymes and direct bilirubin, occurring in patients on long-term PN, particularly with excessive glucose or lipid delivery.