Page 2510 - Saunders Comprehensive Review For NCLEX-RN

PHCP, Primary Health care provider; IV, intravenous; PN, parenteral nutrition.

Adapted from Ignatavicius D, Workman M: Medical-surgical nursing: patient-centered
collaborative care, ed 7, St. Louis, 2013, Saunders.

Box 69-3

Home Care Instructions for Parenteral Nutrition

Therapy

▪ Teach the client and caregiver how to obtain, administer, and maintain
parenteral nutrition fluids.
▪ Teach the client and caregiver how to change a sterile dressing.
▪ Obtain a daily weight at the same time of day in the same clothes.
▪ Stress that if a weight gain of more than 3 lb/week is noted, this may indicate
excessive fluid intake and should be reported.
▪ Monitor the blood glucose level and report abnormalities immediately. Teach
the client how to monitor for and manage hypoglycemia and hyperglycemia.
▪ Teach the client and caregiver about the signs and symptoms of side effects or
adverse effects such as infection, thrombosis, air embolism, and catheter
displacement.
▪ Teach the client and caregiver the actions to take if a complication arises and
about the importance of reporting complications to the primary health care
provider.

▪ For signs and symptoms of thrombosis, the client should report edema of the
arm or at the catheter insertion site, neck pain, and jugular vein distention.
▪ Leaking of fluid from the insertion site or pain or discomfort as the fluids are
infused may indicate displacement of the catheter; this must be reported
immediately.
▪ Encourage the client and caregiver to contact the primary health care provider if
they have questions about administration or any other questions.
▪ Inform the client and caregiver about the importance of follow-up care.

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