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Chapter 100. Parenteral Nutrition

Student Questions

Which one of the following is an appropriate indication for PN?

A. Severe malnutrition with a functional GI tract

B. Fluid and electrolyte deficits

C. Short-bowel syndrome

D. Well-nourished patient, NPO, with a plan to initiate oral feeding in the next 2 days

Answer: C

Option A: Incorrect. Patients with a functional GI tract should first attempt to receive oral or enteral nutrition.

Option B: Incorrect. Fluid and electrolyte deficits should be treated prior to initiating nutrition support, but this alone is not an indication for PN if the patient's GI tract is functioning.

Option C: Correct. Patients with short-bowel syndrome may not have adequate absorption from the GI tract and are at risk of developing nutritional, fluid, and electrolyte abnormalities.

Option D: Incorrect. Data do not suggest a benefit with PN therapy for less than 5 to 7 days especially in well-nourished patients.

Which of the following commercially available concentrations of lipid injectable emulsions (ILE) is FDA-approved ONLY for infusion in a total nutrient admixture (TNA) or 3-in-1 admixture (ie, should not be directly infused into the patient or via Y-site)?

A. 10%

B. 15%

C. 20%

D. 30%

Answer: D

Option A: Incorrect. 10% ILE may be used in a 3-in-1/TNA or may be infused directly into a patient via a 2-in-1 admixture.

Option B: Incorrect. There are no commercial ILE formulations in the United States with a concentration of 15%.

Option C: Incorrect. 20% ILE may be used in a 3-in-1/TNA or may be infused directly into a patient via a 2-in-1 admixture.

Option D: Correct. The 30% ILE formulations are only approved for compounding/admixing in a TNA or 3-in-1 admixture and should not be directly infused into a patient.

Which of the following is an advantage of a 2-in-1 PN formulation over a TNA or 3-in-1 PN formulation?

A. Administration of a 2-in-1 formulation is easier for a patient (eg, in the home setting).

B. Decreased risk of contamination with a 2-in-1 PN formulation

C. A 0.22-μ in-line filter may be used with a 2-in-1 PN formulation (non-ILE portion).

D....

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