CENTRAL AND PICC LINE INSERTION AND TPN ADMINISTRATION




What is TPN?
  TPN is Total Parenteral Nutrition. It is a type of nutrition which is given
                            intravenously. It is ordered by the doctor and the goal is to deliver enough   
                             calories to promote adequate nutrition and healing.Typically, it is used for
                             patients who cannot eat or drink.
    

Indications for TPN include:
- comatose patients
- abdominal surgery
- trauma and peritonitis

In the image below, two patients have TPN ordered. 
1) Melissa was involved in a car accident and sustained
abdominal injuries. She developed peritonitis and cannot
eat or drink.
2) Sheila is in a coma and cannot eat or drink. TPN is 
her only nutrition.


Complications of TPN
Infection, elevated blood glucose and venous thrombosis
may occur with the use of TPN. It is important to note that
TPN should not be discontinued abruptly. The doctor usually
orders it to be tapered off.


When TPN is ordered by the doctor, a Central line is placed in 
the jugular vein in the neck or a PICC line is inserted in the arm
for infusion of the TPN.

TPN is then prepared by the pharmacist and administered per
MD orders. It is a sterile solution. 

Care should always be taken by the nurse, to avoid infection. Hand
washing and the use of gloves is usually done.
 
Dressings as well as IV tubing changes are done per unit's protocol.
A filter is attached to the IV tubing prior to administration. 
To learn more, just click on the link:

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