TOTAL PARENTERAL NUTRITION (TPN) ADMINISTRATION
- Antibacterial soap for hand washing
- TPN solution bag
- I.V. tubing with appropriate air eliminating in-line filters with anti-siphon valve
- Appropriate volumetric infusion device
- Antiseptic pads or swabs
- Sharps container
- 2 Prefilled Saline syringes
- 1 Prefilled Heparin syringe
- Additive medications and syringes
- Prepare a clean working area
- Assemble and prepare the supplies and equipment.
- Check TPN label for:
- correct patient’s name
- expiration date
- correct solution
- Look at the TPN solution for cloudiness, floating matter, cracks or leaks
- Wash hands. Dry with a clean paper towel.
- The TPN solution should be warmed to room temperature. Remove from the refrigerator ____ hours as instructed before the next bag is to be hung.
- Add multivitamins and/or other medications (see preparation of medication from a vial procedure).
- Check I.V. tubing and in-line filter. Check for defects or problems.
- Replace TPN and tubing every 24 hours.
- Make sure the clamp is closed.
- To connect the TPN to the I.V. tubing:
Remove the protective cap from the administration port on the TPN container (DO NOT TOUCH THE PORT with your fingers).
- Remove the protective cap from the I.V. tubing set spike (DO NOT TOUCH THE SPIKE)
- Carefully insert the spike of the I.V. tubing into the TPN administration port.
- Hang TPN bag on the I.V. pole.
- Connect the I.V. tubing to the infusion pump as instructed. Prime the tubing through the pump.
- Scrub the catheter injection cap with an antiseptic pad or swab; allow drying.
- Flush your IV access device with saline (follow the SASH Administration Protocol) prior to starting the TPN infusion.
- Connect the I.V. tubing to the IV access device catheter injection cap via a luer-lock connection.
- Turn on the pump. Open the clamp.
- Begin the infusion.
- Close the clamp. Turn off pump.
- Disconnect TPN tubing from IV access device injection cap.
- Clean the catheter injection cap with an antiseptic pad or swab; allow drying thoroughly.
- Flush I.V. catheter with Saline followed by heparin per the SASH administration procedure.
- When the TPN is almost empty or when it is time to change the TPN (24 hours), prepare new container. Close the roller clamp on the I.V. tubing.
- Repeat the procedure and hang a new TPN solution.
NOTE: CHANGE THE I.V. ADMINISTRATION SET EVERY 24 HOURS. FLUSH CATHETER AS DIRECTED BY NURSE.
Discard all USED supplies in the appropriate container.
Contact your nurse IMMEDIATELY if any of the following signs occur:
- chest pain
- significant increase or decrease in weight
- swelling in lower legs
- dizziness or fainting
- pain at I.V. site
- swelling or hardness around IV site
- leaking or drainage around IV site or dressing
- redness/heat at IV site or coldness at IV site
NOTE: NEVER EXPOSE TPN TO DIRECT SUNLIGHT.
If the infusion is intermittent or cycled:
At the end of the intermittent infusion:
If the infusion is continuous:
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