Page 139 - Demonstrating skill coppysaved colored-converted

Short-bowel syndrome: small-bowel resection of 75% or more to control diarrhea and
prevent dehydration and malnutrition
Cancer clients receiving chemotherapy or radiation therapy
Long-Term (greater than 2 weeks)
 Hyperemesis gravida rum
 Low-birth weight neonates
 Failure to thrive
 Intractable diarrhea
 Severely burned clients

Precaution
Verify placement of feeding line before administration of liquids.
Administer nutrients under the prescribed time interval.
Keep PN refrigerated; remove from refrigerator 30 minutes before administration.
Change PN tubing every 24 hours.
Equipment
1. TPN solution
2. IV controllers or pumps
3. Appropriate IV tubing with filter
4. IV pole
5. TPN dressing kit
6. Sterile Gloves and mask
7. Blood glucose monitoring equipment

Procedure
1. Schedule and assist the client with chest x-ray after central catheter insertion
2. Confirm the correct solution is running at the order rate.
3. Check the solutions expiration date.
4. Use an infusion controller to monitor and regulate the flow rate
5. Inspect tubing and catheter connection for leaks or kinks. Tape all connections. Change
tubing every 24 hours accordingly to agency policy
6. Inspect insertion site for infiltration thrombophlebitis or drainage. If present, notify the
physician. Note the physician may order the removal of the catheter and culture of the
catheter tip
7. Monitor vital signs, including temperature every 4 hours
8. Assess for symptoms of air embolism (i.e., decrease level of consciousness, tachycardia,
dyspnea, anxiety," feeling of impending doom”, chest pain, cyanosis, and hypotension)
Note: if suspected, lay clients on the left side with head in Trendelenburg position.

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