TPN is used for patients who cannot or should not
get their nutrition through eating. Your TPN may include
a combination of sugar and carbohydrates (for energy),
proteins (for muscle strength), lipids (fat), electrolytes,
and trace elements. Your solution may contain all
or some of these substances, depending on your condition.
Even though TPN often includes lipids, it will not
make you fat. Everyone needs calories, protein, and
fat, in addition to other substances, to stay healthy.
Electrolytes include sodium, potassium, chloride,
phosphate, calcium, and magnesium. Trace elements
include zinc, copper, manganese, and chromium. Electrolytes
are important for maintaining almost every organ in
your body. They help your heart, muscles, and nerves
to work properly and keep you from becoming dehydrated.
Your health care provider (doctor, nurse, or pharmacist)
may measure the effectiveness and side effects of
your treatment using laboratory tests and physical
examinations. It is important to keep all appointments
with your doctor and the laboratory. The length of
treatment depends on how you respond to the medication.
| Precautions Before administering total
parenteral nutrition,
- tell your doctor and pharmacist if you are
allergic to any drugs.
- tell your doctor and pharmacist what prescription
and nonprescription medications you are taking,
especially dexamathasone (Decadron); medications
for diabetes, high blood pressure, or heart
disease; prednisone; tetracycline; and vitamins.
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- tell your doctor if you have or have ever
had diabetes or heart, kidney, liver, lung,
or Addison's disease.
- tell your doctor if you are pregnant, plan
to become pregnant, or are breast-feeding, so
that the risks and benefits of receiving TPN
can be discussed. If you continue to receive
TPN while you are pregnant or breast-feeding,
your doctor may change the combination of sugar,
protein, fat, and other elements.
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Administering your medication
Before you administer TPN, look at the solution closely.
It should be clear and free of floating material.
Gently squeeze the bag or observe the solution container
to make sure there are no leaks. Do not use the solution
if it is discolored, if it contains particles, or
if the bag or container leaks. Use a new solution,
but show the damaged one to your health care provider.
It is important that you use your medication exactly
as directed. Do not change your dosing schedule without
talking to your health care provider. Your health
care provider may tell you to stop your infusion if
you have a mechanical problem (such as a blockage
in the tubing, needle, or catheter); if you have to
stop an infusion, call your health care provider immediately
so your therapy can continue.
Side effects
Although side effects from total parenteral nutrition
are not common, they can occur. Tell your health care
provider if any of these symptoms are severe or do
not go away:
- mouth sores
- poor night vision
- skin changes
If you experience any of the following symptoms,
call your health care provider immediately:
- fever or chills
- stomach pain
- difficulty breathing
- rapid weight gain or loss
- increased urination
- upset stomach
- vomiting
- confusion or memory loss
- muscle weakness, twitching, or cramps
- swelling of the hands, feet, or legs
- thirst
- fatigue
- changes in heartbeat
- tingling in the hands or feet
- jumpy reflexes
- convulsions or seizures
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Storing your medication
- Your health care provider probably will give
you a several-day supply of total parenteral nutrition
at a time.You will be told to store it in the refrigerator
or freezer.
- Take your next dose from the refrigerator 4-6
hours before using it; place it in a clean, dry
area to allow it to warm to room temperature.
- If you are told to store additional total parenteral
nutrition in the freezer, always move a 24-hour
supply to the refrigerator for the next day's use.
- Do not refreeze medications.
Store your medication only as directed. Make sure
you understand what you need to store your medication
properly.
Keep your supplies in a clean, dry place when you
are not using them, and keep all medications and supplies
out of reach of children. Your health care provider
will tell you how to throw away used needles, syringes,
tubing, and containers to avoid accidental injury.
In case of emergency/overdose
In case of overdose, call your local poison control
center at 1-800-222-1222. If the victim has collapsed
or is not breathing, call local emergency services
at 911.
Signs of infection
If you are receiving TPN in your vein or under your
skin, you need to know the symptoms of a catheter-related
infection (an infection where the needle enters your
vein or skin). If you experience any of these effects
near your intravenous catheter, tell your health care
provider as soon as possible:
- tenderness
- warmth
- irritation
- drainage
- redness
- swelling
- pain
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