Which instruction will the nurse include in discharge teaching for a client who will be receiving total parenteral nutrition?

Overview

Total parenteral nutrition (TPN) is liquid nutrition given through a tube (IV) that is put in a large vein in the arm, neck, or chest. You may need TPN because of a condition that makes it hard to eat or because of a severe illness, such as Crohn's disease or pancreatitis.

TPN is usually given for 12 to 14 hours each day. You may be able to get TPN while you sleep. Your doctor may recommend that a nurse visit you at home to help you get started with TPN.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

To care for your IV

• Follow your doctor's instructions for use and care of your IV. Your doctor, nurse, or other health professional will:
  • Tell you what fluids to give through the IV.
  • Show you how to care for the skin around the IV. Be sure to follow instructions on keeping the area clean.
  • Teach you how to watch for infection or blockage of the IV.

To give TPN

• Follow your doctor's instructions for giving TPN. Do not change the dose or how often you get TPN without talking to your doctor first.
• Wash your hands before you handle the TPN solution and supplies, or the IV.
• Store the TPN solution in the refrigerator when you are not using it. Let the solution warm to room temperature before you use it. You can do this by placing the TPN bag on a clean table or kitchen counter for 2 to 3 hours before you use it. Never microwave the solution.
• Always check each bag of TPN before you use it. If there is a problem with your TPN, save the bag and show it to your doctor or pharmacist.
  • Check the expiration date. Do not use it if it is past the expiration date.
  • Check the bag for leaks. Do not use it if there are any leaks.
  • Check the colour of the TPN solution. Do not use the TPN if it is cloudy or has solid pieces floating in it.
• Follow your doctor's instructions on how to safely dispose of used IV needles, IV tubing, and TPN bags.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).

Call your doctor or nurse call line now or seek immediate medical care if:

• You have signs of infection, such as:
  • Increased pain, swelling, warmth, or redness around the IV.
  • Red streaks leading from the area where the IV is put in.
  • Pus draining from the IV area.
  • A fever.
• The IV comes out.
• You are dizzy or light-headed, or you feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

• Your weight goes up or down more than 2.3 kilograms in a week.
• You have any problems with your TPN.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter Y938 in the search box to learn more about "Total Parenteral Nutrition (TPN): Care Instructions".

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