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What is Parenteral Nutrition? - Total, Partial & Peripheral

Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

Parenteral nutrition is nutrition that is given into the vein instead of the stomach. This is used when someone is unable to eat enough nutrients. This lesson will discuss total, partial, and peripheral nutrition.

Nutritional Needs

Stan is a new nurse and is working on a surgical unit in a hospital that specializes in stomach and bowel surgeries. He is taking care of his first patient that needs parenteral nutrition after having part of their stomach removed due to cancer. The nurse orienting Stan is named Jane and is explaining what parenteral nutrition is and how it is monitored.

What is Parenteral Nutrition?

Parenteral nutrition is a solution that is given intravenously (through the vein). It is used to provide either extra nutrients or all of the nutrients to a person who is not eating enough or is unable to eat. Parenteral nutrition can be used long term and short term. It is commonly used for a short period of time to promote proper nutrition during an illness or treatment until normal consumption of food can return.

Parenteral nutrition solution
Parenteral nutrition solution

Parenteral nutrition is managed by a dietician to ensure that there is an appropriate amount of electrolytes, proteins, carbohydrates, fats, amino acids, and fluids for each situation. The person receiving parenteral nutrition is monitored closely to make sure that enough of the right combination of nutrients is being supplied. Various tests are completed. When first started, parenteral nutrition monitoring is done frequently and then done less frequently as time goes on.

  • Weight is monitored daily
  • Blood work such as CBC (complete blood count), electrolytes, and kidney function is done daily to make sure the levels are correct and organ function is stable.
  • Blood work such as liver function tests, plasma proteins, magnesium, phosphate, plasma and urine osmolality, and calcium are tested two times a week to make sure the levels are maintained.
  • Blood glucose should be checked at six-hour intervals when first starting to avoid hyperglycemia or hypoglycemia.
  • Fluid intake and output are monitored to ensure there is no retention of fluid.

Now that Stan understands the basics of parenteral nutrition, Jane is educating him on the different types of parental nutrition that he will be giving while working on the surgical unit. Different types are used to guarantee a patient will receive enough nutrients to help with recovery.

Total Parenteral Nutrition

Total parenteral nutrition (TPN) is a solution that supplies all of the required nutrients that someone needs on a daily basis. This is given to someone who is unable to eat or get any nutrients on their own. It is given intravenously through a central line. A central line is a catheter that is inserted into a large vein called the superior vena cava. There are several different types of central lines.

  • Subclavian or femoral central line: catheter inserted at the neck or femoral area that is threaded through the vein to end at the superior vena cava, usually used for short term
  • Peripherally inserted central catheter (PICC): catheter inserted in the arm and threaded to the superior vena cava, usually used for long term treatments
  • Groshong and Hickman lines: catheters that are inserted into the chest and threaded to the superior vena cava, usually used for long term treatments

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