Fluid therapy parenteral nutrition

When normal enteral feeding in not possible or is inadequate to meet an individual s nutritional needs, intravenous (IV) nutritional therapy or total parenteral nutrition (TPN) is required. Products used to meet the IV nutritional requirements of the patient include protein substrates (amino acids), energy substrates (dextrose and fat emulsions), fluids, electrolytes, and trace minerals (see the Summary Drug Table Electrolytes). 

Adjunctive therapy with fluid and electrolyte replacement should be initiated. Nutritional support with enteral or parenteral nutrition may be indicated for patients unable to eat for more than 5 to 7 days.2 Some evidence suggests that enteral nutrition provides anti-inflammatory effects in patients with active CD.40,41... 

Plasmanate Contains protein and fluid. Treats shock where there is a loss of plasma, but not a loss of red blood cells. Not administered to patients who have anemia, increased blood volume, or CHF. Lipids Lipids are a fat emulsion used to provide essential fatty acids for prolonged parenteral nutrition. Also used for IV therapy that extends longer than 5 days. 

Most hospitals have a computerized CIVAS that is integrated into the unit-dose distribution system. Preparations handled in these units include cytotoxic drugs, antibiotics, parenteral nutrition, other drugs, and therapy with fluids (Fig. 4). References to Spanish articles dealing with recommendations for managing these units can be found in the bibliography.Protocols must include every procedure carried out in the unit, from preparation to identification, hazard handling, waste treatment, and so on. In Spain, admixtures and nutritional preparations are normally prepared by pharmacy nurses supervised by pharmacists. 

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