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Total parenteral nutrition

Hyperalimentation; TPN; Malnourishment - TPN; Malnutrition - TPN

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Description

Total parenteral nutrition (TPN) is a method of feeding that bypasses the gastrointestinal tract. A special formula given through a vein provides most of the nutrients the body needs. The method is used when someone can't or shouldn't receive feedings or fluids by mouth.

You'll need to learn how to do TPN feedings at home. You'll also need to know how to care for the tube (catheter) and the skin where the catheter enters the body.

Follow any specific instructions your nurse gives you. Use the information below as a reminder of what to do.

What to Expect at Home

Your doctor will select the right amount of calories and TPN solution. Sometimes, you can also eat and drink while getting nutrition from TPN.

Your nurse will teach you how to:

It is very important to wash your hands well and handle supplies as your nurse told you, to prevent infection.

You will also have regular blood tests to make sure the TPN is giving you the right nutrition.

Preventing Infection

Keeping hands and surfaces free of germs and bacteria will prevent infection. Before you start TPN, make sure the tables and surfaces where you will put your supplies have been washed and dried. Or, place a clean towel over the surface. You will need this clean surface for all of the supplies.

Keep pets as well as people who are sick away. Try not to cough or sneeze on your work surfaces.

Wash your hands thoroughly with an antibacterial soap before TPN infusion. Turn on the water, wet your hands and wrists and lather up a good amount of soap all over for at least 15 seconds. Then rinse your hands with fingertips pointing down before drying with a clean paper towel.

Getting the TPN Bag Ready

Keep your TPN solution in the refrigerator, and check the expiration date before use. Throw it away if it is past the date.

DO NOT use the bag if it has leaks, change in color, or floating pieces. Call the supply company to let them know if there is a problem with the solution.

To warm the solution, take it out of the refrigerator 2 to 4 hours before use. You can also run warm (not hot) sink water over the bag. DO NOT heat it up in the microwave.

Before you use the bag, you will add special medicines or vitamins. After washing your hands and cleaning your surfaces:

Using the Pump for TPN

Your nurse will show you how to use the pump. You should also follow the instructions that come with your pump. After you infuse your medicine or vitamins:

When to Call the Doctor

Call your health care provider if you:

References

Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Nutritional management and enteral intubation. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2016:chap 16.

Ziegler TR. Malnutrition, nutritional assessment, and nutritional support in adult hospitalized patients. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 217.

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Review Date: 10/28/2018  

Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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