We've had TPN at the LTC facility I work at. Not often though. Things that come to mind immediately are: Daily weights, I&0, Accuchecks every 6 hours with sliding scale insulin, frequent labs, 2 nurses need to compare TPN and additives against orders before hanging, change bag and tubing with filter every 24 hours, use a 1.2 micron filter, if adding additives- use strict sterile technique and preferably and RN should add (check with your facilities policy about LPN's handling TPN), PICC line or central line used with a designated port for TPN only, if TPN needs to be stopped you must hang dextrose 10% at the same rate the TPN was running at - so always have a bag or 2 available, respiratory assessment at least every shift, vital signs at least every shift sometimes temp more often.
|
Would you like to comment?
