Total Parenteral Nutrition
What is it?
Total Parenteral Nutrition Care Guide
- Total Parenteral Nutrition
- En Espanol
Total Parenteral (per-IN-ter-ull) Nutrition (new-TRIH-shun) is also called TPN. It provides your body with nutrition such as protein, sugar, vitamins, minerals, and sometimes fat (lipids). TPN is used when you are unable to eat or cannot get enough nutrition from the foods you eat. TPN always goes into your vein (blood vessel) through an intravenous (in-truh-V-nus) (IV) line. It may be given to you in the hospital, long-term care center, or at home. You may need TPN for several days or longer. This will be decided by your caregiver.
Who needs TPN?
TPN is needed when you cannot eat food by mouth. You may need TPN if you cannot get enough nutrition from your diet for seven days or more. You may also need TPN if you have:
- Infection or problems in your pancreas, intestines (bowel), or other body organs.
- Food tubes going into your stomach that cannot give you enough nutrition.
- AIDS (acquired immunodeficiency syndrome).
- Some types of cancer.
- Starvation or anorexia (an-or-EKS-e-uh). These are problems that occur when you do not eat for a long time.
- Serious burns.
If you have any of the following, tell your caregiver before you start your TPN treatment:
- Allergies, especially to vitamins, eggs, oils, or peanuts.
- Blood clotting problems.
- High blood cholesterol (ko-LES-ter-all).
- Liver, kidney, or heart disease.
- Pancreas problems such as pancreatitis (pan-kree-uh-TI-tis).
- Pregnant or breast feeding.
How is TPN given?
Your caregiver will place a special IV line in your arm, upper chest, or neck. Your TPN will be connected to a pump. It controls how fast the TPN goes into your vein. Your TPN will be given by a caregiver who is trained to give IV treatments.
What will happen when I leave the hospital?
You will receive your first dose of TPN while you are in the hospital. This will help your caregiver decide what type of TPN to give you at home. Ask your caregiver for information on how to care for your IV line. A caregiver will visit you at home and give the TPN to you. The caregiver may also teach you, a family member, or friend how to give the TPN.
Checklist for giving a TPN treatment:
Your TPN and supplies will be delivered to your home. TPN is usually kept in the refrigerator. Ask your caregiver how you should store the TPN and for how long. Do not freeze the bags.
- 1. __ Remove your TPN from the refrigerator two hours before you plan to use it. Allow it to warm to room temperature. Do not warm your TPN in a microwave oven.
- 2. __ Check the expiration date on the label. Do not use the TPN if it is expired (past the date on the label).
- 3. __ Look closely at the liquid in the TPN bag. Do not use it if the TPN is cloudy or has solid pieces floating in it. Do not use your TPN if it is separated like oil and water or is leaking from the bag. Call your caregiver and ask your caregiver what you should do.
- 4. __Wash your hands.
- 5. __ Place all your supplies on a clean, hard surface like a table. Gently rock your TPN bag up and down and back and forth. This will blend the liquid in the bag. Never shake your bag. Follow your caregiver's instructions on how to give your TPN.
- 6. __ You may need to add vitamins or medicine to the TPN bag before it is given. Your caregiver will show you how. The vitamins will make your TPN bag turn yellow. This is normal.
- 7. __ Throw away used IV supplies in a special container. This special container will be given to you by your caregiver. Keep it where children and pets cannot reach it. When it is almost full, tell your caregiver. Do not dispose of it yourself.
- 8. __ Call your caregiver if you have problems with your TPN treatment. Call if your TPN has expired or there are problems with the liquid in the bag. Also call if your pump is not working or if you see leaks in the bag or IV supplies. Call if you have any other questions or concerns about your TPN.
What do I do if I miss a dose?
Your TPN should be given at about the same time everyday. If you miss a TPN treatment or forget to add in a medicine, call your caregiver immediately.
What kind of care can I expect at home?
Your caregiver will tell you what you need to do every day while on TPN. This may include weighing yourself, keeping a food diary, and testing your blood sugar. You will be given special papers to record (write down) this information each day. Your caregiver will teach you how to do all these things. Your caregiver will visit you every one to three days at first. Once you have had TPN treatments for a while, your caregiver will come less often. You can expect your caregiver to draw your blood, speak to you about how you are feeling, and look at your daily recordings. Your caregiver will also check your IV site for infection (in-FECK-shun) or leaks.
Call your caregiver if you have:
- You have more weight gain or loss than your caregiver tells you is ok.
- You have a fever.
- Redness, swelling, or leaking where your IV goes into your skin.
- Vomiting (throwing up) or diarrhea (di-uh-REE-uh). Also, if you are very thirsty, and drinking liquids does not make the thirst go away.
- Dizziness or you feel like you are going to faint (pass out).
- Problems getting your IV line to work.
- A yellow color to your skin or whites of your eyes.
- Questions or concerns about your TPN treatment, illness, or care.
Seek care immediately if:
You have chest pain or trouble breathing. Call 911 or "0" for the operator. This is an emergency. Do not drive yourself.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.