Complications Associated with Total Parenteral Nutrition Dehydration and electrolyte Imbalances. Thrombosis (blood clots) Hyperglycemia (high blood sugars) Hypoglycemia (low blood sugars)
What is the most common complication of total parenteral nutrition?
Fatty liver is the most common complication, whereas intrahepatic cholestasis or hepatitis are less frequent.
What is a potential complication of refeeding syndrome caused by parenteral nutrition therapy for a patient with starvation?
Refeeding syndrome appears when food is introduced too quickly after a period of malnourishment. Shifts in electrolyte levels can cause serious complications, including seizures, heart failure, and comas. In some cases, refeeding syndrome can be fatal.
What is refeeding syndrome with TPN?
Refeeding syndrome can be defined as the potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding (whether enterally or parenterally5). These shifts result from hormonal and metabolic changes and may cause serious clinical complications.
What are the most common errors associated with parenteral nutrition?
Fat emulsions and electrolytes were the PN ingredients most frequently associated with error. Insulin was the ingredient most often associated with patient harm.
What is complication of long term TPN?
Complications of Total Parenteral Nutrition Clotting (thrombosis) in central access veins. Frequent infections in the central-vein access lines. Inflammation of the gallbladder (cholecystitis) Bone disease (osteoporosis) TPN-induced liver damage or liver failure.
When should TPN be discontinued?
Guidelines suggest that when tolerance to enteral nutrition is evident, parenteral nutrition should be weaned and discontinued when >60 percent of the patients’ needs are met enterally, although there are no data to support this practice [1].
Which adverse effect occurs when there is too rapid an infusion of TPN solution?
The rate is too fast and rapid for the client. The signs and symptoms of fluid overload include hypertension, edema, adventitious breath sounds like crackles and rales, shortness of breath, and bulging neck veins.
Does TPN have side effects?
A person on TPN can develop high blood glucose levels (hyperglycemia). 8 One reason a person on TPN might be more likely to develop high blood sugar is that their body is under stress.
What are 2 major complications from anorexia nervosa?
- Anemia.
- Heart problems, such as mitral valve prolapse, abnormal heart rhythms or heart failure.
- Bone loss (osteoporosis), increasing the risk of fractures.
- Loss of muscle.
- In females, absence of a period.
- In males, decreased testosterone.
- Gastrointestinal problems, such as constipation, bloating or nausea.
What does refeeding syndrome look like?
Your patient with refeeding syndrome may develop muscle weakness, tremors, paresthesias, and seizures. Institute seizure precautions. In addition, she may have cognitive changes, including irritability and confusion. These cognitive changes make her safety a priority.
What does refeed syndrome feel like?
In the refeeding process, the release of insulin into the bloodstream can decrease phosphorus, potassium, magnesium, calcium and sodium levels in the bloodstream. This causes refeeding syndrome. Symptoms of refeeding syndrome include lightheadedness, fatigues, a drop in blood pressure and a drop in heart rate.
What is the most common metabolic complication of TPN?
Liver steatosis is a frequent complication of TPN. It is associated with elevation of plasma aminotransferases and liver enlargement (modified structure of liver parenchyma on ultrasonography). It is usually caused by overfeeding, particularly with glucose.
What are the symptoms of hypophosphatemia?
- Confusion.
- Appetite loss.
- Muscle weakness.
- Feeling tired and upset.
- Bone pain and fractures.
- Tooth decay or late baby teeth.
- Slow growth and short height in children.
How is TPN used for anorexia nervosa?
The treatment with TPN consisted of using a surgically placed, indwelling tunneled catheter to deliver progressively increased amounts of intravenous calories. This facilitated successful weight restoration.
What is the most serious potential complication with enteral nutrition?
Aspiration. Aspiration is one of the most important and controversial complications in patients receiving enteral nutrition, and is among the leading causes of death in tube-fed patients due to aspiration pneumonia.
What happens if TPN is stopped abruptly?
TPN is usually slowed or discontinued prior to anesthesia, primarily to avoid complications from excessive (hyperosmolarity) or rapid decrease (hypoglycemia) in infusion rates in the busy operative arena. That said, because abrupt discontinuance may lead to severe hypoglycemia, TPN must be turned down gradually.
Is TPN a high risk medication?
Introduction: The Institute for Safe Medication Practices has stated that parenteral nutrition (PN) is considered a high-risk medication and has the potential of causing harm.
How long is too long to be on TPN?
The median time from initiation of TPN to death was 5 months (range, 1-154 months). Sixteen patients survived >or=1 year. TPN-related complications included 18 catheter infections (1 per 2.8 catheter-years), 4 thromboses, 3 pneumothoraces, and 2 episodes of TPN-related liver disease.
How long can a patient stay on TPN?
For many, it’s three to 12 months of therapy where the amount of TPN needed reduces over time. Your body adapts fully to surgery after about one to two years and people are usually able to reduce how much TPN they’re dependent on.
Why should TPN not be stopped?
It is important to keep track of all the fluids infusing (IV fluids, IV medications, and TPN) in order to avoid fluid overload (Perry et al., 2014). Do not abruptly discontinue TPN (especially in patients who are on insulin) because this may lead to hypoglycemia.
Do you have bowel movements while on TPN?
Do you have bowel movements while on TPN? Patients on TPN do experience bowel movements, although not as frequently. The digestive system will continue to produce digestive fluids and shed old cells, which will need to be expelled by the body.
How long does it take to gain weight on TPN?
The average weight gain was 2.6 kg for those who received TPN less than 2 wk and 4.5 kg if TPN was given for greater than 2 wk.
Is refeeding syndrome a complication of TPN?
As mentioned above, patients who suffer from refeeding syndrome are usually hypophosphatemic, as well as hypomagnesemic and hypokalemic. TPN can exacerbate these conditions, especially secondary to glucose loading (leading to hypophosphatemia, as described above, as well as insulin release and worsened hypokalemia).
Does TPN cause hyper or hypoglycemia?
The risk of both hyper- and hypoglycemia is increased at the start and conclusion of the daily infusion.