Peripheral Parenteral Nutrition: Definition & Guidelines

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  • 0:04 Peripheral Parenteral…
  • 0:48 PPN: Need
  • 1:32 PPN: Solution
  • 2:49 PPN: Administration
  • 4:11 PPN: Complications
  • 5:40 Lesson Summary
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Lesson Transcript
Instructor: Scott Keane

Scott has a Bachelor's degree in Nursing, a Master's degree in Christian Studies, and has taught college level nursing.

Discover how patients receive nutritional fuel when they cannot eat properly. This lesson describes how to safely deliver liquid nutrition into veins.

Peripheral Parenteral Nutrition

If you own a car, you need gasoline to keep it running. In much the same way, your body needs nutrients that provide you with the energy required to go about your daily activities. If you cannot ingest these nutrients or your intestines are not working properly, you must fulfill your nutritional requirements through other means. Parenteral nutrition can be infused directly into your veins in a sterile, liquid form. Total parenteral nutrition (TPN) is administered through the largest vein in your body, the superior vena cava, and provides the majority of your nutritional needs. Peripheral parental nutrition (PPN) is administered through the veins outside the superior vena cava. Let's find out more about PPN.

PPN: Need

If you become ill and cannot eat, sometimes for as long as 4-7 days, you'll most likely become dehydrated and lose a lot of weight, in addition to other possible health problems. The most common reasons for severe weight loss requiring replacement nutrition include abscesses, bowel inflammation, cancer, complicated intestinal surgeries, fistulas, highly draining wounds, intractable diarrhea, and malabsorption syndromes. If you're expected to regain the ability to eat in a relatively short period of time, you can have your nutritional protein, carbohydrates, and fat supplied through your peripheral veins. This can help to maintain brain and organ function and aid in your recovery.

PPN: Solution

Your body uses three main nutritional sources: carbohydrates for energy, fats for energy and storage, and proteins for structure. Intravenous nutritional solutions provide these elements in the form of amino acids (protein), dextrose (carbohydrate), and emulsified lipids (fat). The amino acids and dextrose in this solution can be very irritating to your veins. To help prevent vessel damage, the concentration of these elements is limited. For example, D10W, or 10% dextrose in water, is the highest concentration of sugar used in peripheral parenteral nutrition. It's twice as concentrated as your average blood sugar.

Protein and fat concentrations are also limited. The maximum amino acid concentration is a 5% solution. Acceptable lipid concentrations are no higher than 20% peripherally. Lipid emulsifications are also much less irritating than a dextrose-amino acid solution. Lipids may be given in a separate bottle or mixed with a dextrose-amino acid solution. The mixed solution is less irritating to vein walls. To provide the remaining nutritional requirements, electrolytes, minerals, and vitamins are added to the solution.

PPN: Administration

Any infusing parenteral nutritional solution can cause serious harm, but there are a few ways to decrease the chance of damage. One approach is to use the peripheral veins with the largest diameters, which allows the solution to be diluted in the maximum blood flow. These veins are the basilic, cephalic, and median arm veins. The solution flows out of the intravenous catheter tip, which is placed in the veins with the greatest blood flow. An IV catheter pump allows the solution to flow at a consistent, safe rate. Since the peripheral solution is less concentrated than the central line solution given in the superior vena cava, pump rates may be fairly rapid. This also allows more fluid to be infused peripherally to provide more nutrients. A filter in this venous catheter tubing prevents any large particles from infusing.

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