TOTAL

PARENTERAL
NUTRITION
Ma. Rodessa P. Laganapan, R.N.
University of Santo Tomas Hospital
 ANSAP
Procedural Guidelines on
TPN Administration
 TPN Utilizing
Peripheral Access
 1) Verifies doctor‘s orders
2) Explain the procedure to reassure
patient & relatives (benefits,risks,
duration, etc.)
'

3) Secure/witness signing of consent

4) Prepare parenteral solution & other
devices needed
5) Assess patient & choose suitable
veins,location, & baseline VS
6) Check the integrity & functionality of
the parenteral solution & IV devices
7) Observe the 10 R ‘s in safe drug
administration
8) Do hand hygiene & maintain asepsis
throughout the procedure
9) Prepare the TPN solution
10) Insert IV catheter aseptically
11) Connect the tubing to the prepared
parenteral solution & regulate flow
rate as prescribed
12) Dress IV site as per IV standard
13) Label IV site & solution as per IV
standard
14) Continue to reassure patient & do
pertinent health education
15) Dispose waste materials properly
16) Document accordingly
17) Monitor patient periodically & report
unusual findings if any
18) Document observation & intervention as
necessary
19) Reassure patient
 TPN Utilizing
Central Vascular
Access
1) Follow procedures in Peripheral Access
from steps 1-9
2) Assist surgeon in Open or Closed
Central Access Procedures
3) Connect the IV administration set to
the central vascular access catheter
aseptically & regulate flow as
prescribed
4) Assess dressing over central vascular
access for swelling, redness, pain, &
foul smelling discharges; Change
dressing aseptically everyday
5) Monitor & reassure patient
6) Document observations & circumstances
as necessary
7) Discard waste materials properly
 Discontinuing
Parenteral Solution
1) Verify written prescription
2) Observe 10 R‘s
3) Explain the procedure to the patient &
significant others
4) Prepare the necessary materials in
discontinuing TPN utilizing the
Peripheral/Central Vascular Access
5) Follow MD‘s order e.g. electrolyte,
weight, etc.)
6) Refer to MD for any unusual
observations
7) Discard waste materials accordingly
THANK YOU FOR
LISTENING!