TPN in hospice setting?

[AtlantaRN, RN]

patient with lung cancer with mets to liver and bone. Sent home from hospital on TPN...

I've never encountered ivf or tpn in the hospice setting... Is this normal?

((I was an ICU rn for 10 yrs, so way familiar in hospital setting))...

linda

[leslie :-D]

i'm sure it won't last long.

he won't be able to tolerate the fluids...

poor guy.

did anyone try and get them dc'd?

leslie

[aimeee, BSN, RN]

Not normal, but we do it now and then when it would otherwise be a barrier to them getting started on hospice. Usually its the young patients with ovarian CA. I don't think we have ever had a lung CA patient on TPN.

[Allow Mystery]

Admitted a pt on TPN against my objections (no other hospice would take pt and mgmt thought would be good PR). The day I admitted I gave two week notice. Pt suffocated with fluid and died the night before my two weeks were up, a miserable two weeks and a miserable death, but family/physician would hear nothing to stop or slow down the TPN.

It was a young ovarian cancer pt and it was a barrier to them getting

into hospice.

[tencat]

Makes for a miserable death. The one we had puffed up like a balloon and her lungs filled with fluid. I've only seen one on TPN in my job. Ironically, she was a physician, too. Go figure.

[AtlantaRN, RN]

Just came home from a visit with the patient that had had TPN. They stopped it yesterday morning (what a blessing), but he is soooooo wet. Expiratory and inspiratory rhoni. I did turn him over on his side to change brief and pericare and give a tylenol suppository. Also some atropine drops, and 3 pillows under shoulders and two pillows under knees to get him in some sort of high fowlers position....it helped alot with the secretions.

thanks for all the input.

linda

[NRSKarenRN, BSN, RN]

i've used scopolamine patch in past to help dry up secretions...are they still in use?

[leslie :-D]

yep, scope patches are awesome.

leslie