Answer to Question 1
Improperly managed TPN could result in: electrolyte imbalances, hyperglycemia, hyperlipidemia, fatty liver with elevated LFTs, and central line infections.
Answer to Question 2
Standard electrolytes, based on closely monitored blood electrolytes, should be added to each bottle of TPN. Trace minerals should be added to one bottle each day and additional minerals added per results of appropriate labs values, i.e. phosphorus, zinc and magnesium. Since considerable Zn can be lost by ileostomy patients, Zn levels should be checked and appropriate Zn given.