TY  - CHAP
M1  - Book, Section
TI  - Parenteral Nutrition
A1  - Mattox, Todd W.
A1  - Crill, Catherine M.
A2  - DiPiro, Joseph T.
A2  - Talbert, Robert L.
A2  - Yee, Gary C.
A2  - Matzke, Gary R.
A2  - Wells, Barbara G.
A2  - Posey, L. Michael
PY  - 2017
T2  - Pharmacotherapy: A Pathophysiologic Approach, 10e
AB  - Patient  Care  Process  for  Providing  Parenteral  NutritionCollectPatient  characteristics  (e.g.,  age,  race,  sex)Patient  history  (past  medical,  surgical,  family,  social—alcohol  use)Nutrition  history  (dietary  history,  weight  history)Current  medications  (including  nutritional  supplements)Age  appropriate  objective  data  (see  Figure  142-3)Height/length,  weight,  BMI,  head  circumferenceFluid  balance  (intake  and  output)Labs  (e.g.,  serum  electrolytes,  Scr,  BUN,  glucose,  albumin)Vital  signs  (e.g.,  temperature,  pulse  rate,  respiration  rate,  blood  pressure)AssessCurrent  nutrition  status  and  time  period  of  insufficient  nutrient  intakeClinical  conditions  preventing  adequate  oral  nutrient  intakeClinical  conditions  preventing  use  of  enteral  tube  feeding  to  determine  if  an  indication  for  parenteral  nutrition  (PN)  therapy  exists  (see  Tables  142-1  and  142-2)Vascular  accessCurrent  degree  of  metabolic  instability  (e.g.,  hemodynamics,  organ  function,  fluid/electrolyte  status)Appropriate  route  of  PN  (central  or  peripheral)Plan*Design  an  age-appropriate  PN  regimen  that  provides  estimated  nutrient  requirements  and  minimizes  risk  of  causing  adverse  effects  or  worsening  current  metabolic  conditions  (see  Designing  a  Parenteral  Nutrition  Regimen;  Figures  142-1  and  142-2)Monitoring  parameters  for  efficacy  (see  Figure  142-3)Implement*Provide  education  regarding  all  elements  of  treatment  plan  to  patient/caregivers  and  other  members  of  the  healthcare  teamUse  a  standardized  PN  order  form  for  ordering  PN  prescription  to  minimize  risk  of  errorsVerify  the  order  to  ensure  that  it  is  clear,  complete,  and  correctly  transcribedConfirm  stability  of  formulation  and  compatibility  of  ordered  nutrients  and  any  non-nutrient  medicationsDetermine  if  PN  solution  will  be  provided  as  compounded  sterile  preparation  according  to  United  States  Pharmacopoeia  Chapter  797  standards  or  provided  as  a  standardized,  commercially  available  parenteral  nutrition  productDetermine  appropriate  plan  for  patient-specific  monitoring  based  on  the  patient's  clinical  condition  to  anticipate,  prevent  or  treat  mechanical/technical,  metabolic/nutritional,  or  infectious  complications  (Figure  142-3)  Follow-up:  Monitor  and  EvaluateEvaluate  patient  for  mechanical,  metabolic,  and  infectious  complications  (Figure  142-3)Re-evaluate  clinical  conditions  preventing  adequate  oral  intake  or  precluding  use  of  enteral  tube  feeding  to  anticipate  either  transition  off  of  PN  support  or  need  for  continuing  PN  therapy  (Figure  142-3)  *Collaborate  with  patient,  caregivers,  and  other  health  professionals  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/20
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1148581886
ER  -