Describe methods of parenteral nutrition administration, i.e. continuous, cyclic, central, peripheral.

2. Discuss labs for monitoring parenteral nutrition.

3. Describe the possible complications of parenteral nutrition.

4. Identify each part of the nephron and discuss its function.

5. Identify and discuss metabolic abnormalities associated with renal failure.

6. Discuss goals of nutrition therapy in patients with renal failure.

Parenteral Nutrition Information

ROUTES OF INFUSION

Parenteral nutrition, total parenteral nutrition (TPN) or peripheral parenteral nutrition (PPN) is the administration of nutrient (i.e. glucose, amino acids, fat, vitamins and minerals) intravenously either by central or peripheral vein. Indications for use are only when oral or enteral feeding is inadequate or contraindicated. If the gut works, use it first. Solutions vary and depend on calorie, protein, mineral, vitamin, and fluid requirements of the individual.

The components of a parenteral feeding formulation will determine its osmolarity and infusion route. Parenteral nutrition (PN) may be prepared for peripheral venous infusion or infusion through a central venous access device. PN may also be prepared as a total nutrient admixture (TNA) or a “2-in-1” solution. 2-in-1 solutions contain all necessary IV macronutrients and micronutrients in the same container except intralipids, which may be infused separately. Parenteral formulations are hypertonic to body fluids, and, if administered inappropriately, may result in venous thrombosis, thrombophlebitis, and extravasation. Specifically, the osmolarity of a parenteral feeding formulation is dependent primarily on the dextrose, amino acid, and electrolyte content. The maximum osmolarity of PN through a peripheral line is 900 mOsm/L.

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