Tiêu đề NCM 112 RLE SEMI FI ✅

NCM 112 RLE SEMI FI by TONS and MADS Applying a Knowledge of Client Physiology and Mathematics to TPN Interventions ➢ Nurses caring for clients who are receiving TPN must apply their knowledge of the client's physiology into their care of the client. For example, they must apply sterile technique to avoid infection, they must closely monitor the client's blood glucose levels on a continuous basis because the contents of these total parenteral nutrition feedings are high in terms of dextrose content which can lead to hyperglycemia, they must also monitor these levels to determine if the client is being affected by hypoglycemia as a result of the insulin that is administered with these total parenteral nutrition feedings in order to prevent hyperglycemia, and, for example the nurse must monitor the client's intake and output knowing that, physiologically, the high osmolarity of the TPN can lead to osmotic diuresis and fluid imbalances. ➢ Mathematic principles are also applied to TPN interventions in terms of flow rate of the solution which is essentially the same as calculating intravenous flow rates which was fully discussed and described in the section entitled "Dosage Calculations: Performing Calculations Needed for Medication Administration". Administering Parenteral Nutrition and Evaluating the Client Responses Total parenteral nutrition is administered in a similar manner to that which is done with intravenous infusions with a few points of emphasis and differences as listed below. ❖ Total parenteral nutrition feedings are refrigerated until they are ready to hang ❖ Strict sterile asepsis is used. ❖ Regular insulin can be added to the TPN solution to prevent hyperglycemia ❖ Any time that this closed system is opened, as occurs with a tubing or solution bag change, the client must perform the Valsalva maneuver to prevent an embolus and the nurse must perform these tasks as quickly as possible. ❖ The total parenteral nutrition tubing should be changed every 24 hours and the dressing should be changed at least every 24 hours for the first several days of treatment. These changes can vary from facility to facility, so nurses must refer to their facility specific policies and procedures FROM MED SURG Treatment Modalities - Hemo & PD - in RLE VIDEO: Treatment Modalities - not transcribed TREATMENT CHOICES 1. PERITONEAL DIALYSIS a. Removal of waste from the blood through the peritoneum. b. PERITONEUM- is a semi-permeable sack lining the abdominal cavity and covering the abdominal organs. c. HOW DOES PD CLEAN THE BLOOD? i. Diffusion - an area of greater concentration to an area of lower Concentration. ii. The solute transfer across the Peritoneum takes place in both directions. iii. Osmosis - Movement of water from an area of low concentration to an area of high concentration d. TYPES & INDICATIONS i. PD Solution with Dextrose 1.5% - Indicated for patients with low blood pressure in need of dialysis. ii. Sterisol® Low Sodium Peridiasol with Dextrose 2% - Indicated for patients with slightly raised blood pressure or for overloaded diabetic patients. 4