TPN and vitamin injection port

[ougreene]

Hi

OK so tell me fellow nurses, when you have a patient on TPN, and you are hanging a new bag - which you need to add a vial of vitamins to the TPN bag, my question is:

Which port do you inject the vitamins into - a separate "medication port" on the TPN bag OR the port on the TPN bag which you spike with the IV drip line?

I was shown how to do it and I remember told to use the medication port by one nurse, then.... I wanted to see how this other nurse hung the TPN, and she told me NO and preceeded to inject the vial of vitamins into the port in which you spike the TPN bag with. I have not had time to clarify this with the facility or pharmacy yet, but am interested in what others have to say about this.

gail

[resumecpr]

The port used to spike is an "exit only.' in my expereince. I would only inject meds into an injection port...that's what it's there for! I would definitely check with your pharmacist and hospital policy on this matter.

[NRSKarenRN, BSN, RN]

multi vitamins are injected into the separate med port so one can then gently rotate the bag side to side, up and down to distribute med throughout the tpn solution. adding though the iv tubing connector does not allow for even mixing of solution in bag and may permit multivits at tubing spike connection getting large dose @ one time. additionally, contamination of solution may occur if handled syringe tip enters solution.

adding medication to your total parenteral nutrition (tpn ...

inject solution into the bag

• wipe the injection port on the tpn bag with an alcohol pad.
  
• insert the needle into the center of the bag’s injection port.
  
• be careful not to puncture the bag. make sure you have inserted the needle in the center of the bag’s injection port
  
• slowly push the plunger on the syringe, injecting the solution into the bag.
  
• remove the needle.
  
• mix the medication into the tpn solution by gently rocking the bag.
  
• repeat this procedure for each medication or vitamin that needs to be added.
  

http://nih.kramesonline.com/healthsheets/3,s,86576

tpn complications:

http://www.rxkinetics.com/tpntutorial/3_3.html

[ougreene]

Thank you soo much. I knew what I was taught but then I questioned the nurse I was watching..she just threw me for a loop by her reply back to me...like questioning her access through the "exit port" was stupid...

Spiking the bag port is the exit port - that is great! AS adding any additional vitamins etc...in through the injection port!!!!

SO THANK YOU!

:)

Gail

[NRSKarenRN, BSN, RN]

Glad to be of help--- was able to teach 80yo wife this procedure one time ---had better technique than your colleague.

[iluvivt, BSN, RN]

OMG you need to print out those directions and put them into your colleagues mailbox...do it anonymously i you must but DO it. If for any reason I did not want to confront another nurse I would often get the info.... print it.... and put it in their mailbox . I did it for all the patients that would benefit in that nurses future.