Nutritional support therapies parenteral nutrition

Parenteral nutrition support therapy is used for disorders of the GI track, bums, and debilitating disease. Parenteral nutrition support therapy is administered through a central venous line (subclavian or internal jugular veins) to prevent irritation to the peripheral veins. 

Parenteral nutrition support therapy preparation contains ... 

Complications from parenteral nutrition support therapy are ... 

Caution Do not suddenly interrupt parenteral nutrition support therapy. The patient can experience hypoglycemia. Discontinue gradually by decreasing the infusion rate. Monitor for hypoglycemia. 

Parenteral nutritional support therapy is a means of providing high caloric nutrients administered through large veins such as the subclavian vein. 

What is another name for parenteral nutritional support therapy ... 

Parenteral nutritional support therapy does not promote GI function, liver function, or weight gain. 

Name three elements of a parenteral nutrition support therapy preparation. 

Three elements of a parenteral nutrition support therapy preparation are hyperosmolar glucose, amino acids, and vitamins. 

Why is it important to monitor for hyperglycemia when initiating parenteral nutrition support therapy The pancreas may not have time to adjust to the hypertonic dextrose solution, which is high in glucose. Hyperglycemia is usually temporary and dissipates once the pancreas adjusts. 

Other support therapies for AIDS patients that can be given at home are nutrition support, parenteral and enteral, IV immunoglobulins, chemotherapy in lymphoma or Kaposi s sarcoma, and care of terminally ill patients. 

Healthcare professionals can restore or maintain the patient s nutritional balance by administering nutritional support therapy to replace nutrients that the patient lost. There are two types of nutritional support therapies enteral and parenteral. 

Enteral nutritional support therapy introduces nutrition into the patient by mouth or a feeding tube that is directly inserted in the stomach or small intestine. Parenteral nutritional support therapy administers high caloric nutrients through large veins such as the subclavian vein. 

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... 

Parenteral nutrition can be a lifesaving therapy in patients with intestinal failure, but the oral or enteral route is preferred when providing nutrition support ( when the gut works, use it ). Compared with PN, enteral nutrition generally is associated with fewer infectious complications (e.g., pneumonia, intraabdominal abscess, and catheter-related infections) and potentially improved outcomes.1-3 However, if used in appropriate patients (i.e., patients with questionable intestinal function or when the intestine cannot be used), PN can be used safely and effectively and may improve nutrient delivery.4 Indications for PN are listed in Table 97-1.1... 

Further clinical experience and research fostered development of protocols that promoted better patient care and resulted in a decline in complications associated with parenteral nutrition (PN) therapy. The scope of practice for nutrition support clinicians has broadened as a result of increasing knowledge regarding the metabolic consequences associated with acute injury and chronic disease states. The pharmacist s role in providing safe and effective nutrition-support care requires knowledge of the principles of patient selection, initial therapy design, preparation and dispensing of the nutritional formu-... 

The gastrointestinal (Gl) tract is the optimal route for providing nutrients unless obstruction, severe pancreatitis, or other Gl complications are present (see Fig. 136-1). Other considerations that may have an impact on determination of an appropriate route for nutrition support include expected duration of nutrition therapy and risk of aspiration. Patients who have nonfunctional Gl tracts or are otherwise not candidates for enteral nutrition (EN) may benefit from PN. Use of the intravenous route for nutrition support is also commonly referred to as total parenteral nutrition (TPN) or hyperalimentation. Routine monitoring is necessary to ensure that the nutrition regimen is suitable for a given patient as his or her clinical condition changes and to minimize or treat complications early. 

Similarly, for intractable diarrhea in infants, there are no randomized controlled studies comparing TPN to starvation. However, two small experiences have been reported with 100% survival in an illness which historically has a 40% mortality rate (Hyman et al, 1971 Keating and Ternberg, 1971). The results of these and similar studies have made parenteral nutritional support an integral part of the therapy of this condition. 

Overall, nutrition therapy is a component of medical treatment that includes oral, enteral, and parenteral nutrition (PN). However, a meta-analysis provided no evidence that nutritional support has a significant effect on anthropometric measures, lung function, or exercise capacity in patients with stable COPD (25,26). By contrast, repeated administration of ghrelin, a novel growth hormone- releasing peptide that is reduced in COPD (27), may improve body composition, muscle wasting, and functional capacity in cachectic patients with COPD, thus possibly reversing some of the systemic aspects of COPD (28). 

Nutrition is utilized to provide general support for the debilitated patient with a chronic illness. Often, patients are deficient in protein, calories, potassium, vitamins, etc. The healing process is impaired by poor nutrition and is enhanced by proper nutrition. In some cases enteral nutrition is not practical or is impossible. With the techniques of total parenteral nutrition, it is now possible to provide nutritional support for almost all types of patients. Specific nutritional therapy is necessary in certain types of metabolic and related diseases. Nutritional therapy is essential in conditions where specific food intolerances are the basis for a disease. 

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