A medical student asks your opinion or ordering enteral versus ...

[vinney12]

A medical student asks your opinion or ordering enteral versus total parentral nutrition (TPN) for a middle aged man receiving radiation and chemotherapy for neck cancer. Your best response would be:
 
  1. TPN would be the easiest to manage in an outpatient setting.
   2. Clients receiving TPN require daily monitoring a visiting nurse.
   3. Enteral nutrition would be the best choice because the client has a functional digestive tract.
   4. Enteral nutrition would be more difficult to administer on a outpatient basis.

Question 2

A nurse who is caring for a client receiving total parentral nutrition (TPN) must be careful to:
 
  1. Follow the facility protocol for tapering TPN and monitor the input and output for the client each shift.
   2. Decrease the amount of TPN slowly based on the oral intake of the patient.
   3. Follow the facility protocol for tapering TPN, especially monitoring blood sugar levels.
   4. Stop TPN in the morning and resume oral feeding beginning with clear liquids.

[mammy1697]

Answer to Question 1

3
Rationale: Parentral nutrition requires close monitoring and administration must follow a strict protocol. Because of the components of TPN, regular BS measurements to avoid hypo- or hyperglycemia ice episodes are needed. Enteral nutrition has been shown to have economic and health benefits over parentral nutrition among clients with functional digestive tracts. Most clients can manage self-feeding with enteral nutritional supplements following education and demonstration by a nurse.

Answer to Question 2

3
Rationale: Each facility has a protocol or policy for tapering TPN that must be followed closely. TPN must be tapered slowly since sudden cessation of high dextrose solutions can lead to hypoglycemia and can be life threatening. Therefore, careful monitoring of blood sugar is important. TPN should never be stopped abruptly.

[vinney12]

TYSM

[bdobbins]

Thanks for the timely response, appreciate it