Nursing Interventions for TPN (Total Parenteral Nutrition) Patients

TPN = IV nutrition for patients unable to tolerate enteral feeding. Nursing care is intensive.

Key Interventions

1. Fluid/Electrolyte Balance: Daily weights, strict I&O, adjust TPN electrolytes per labs (K, Mg, Phos, Ca).
2. Nutritional Monitoring: Weekly prealbumin, transferrin, nitrogen balance; glucose q6h initially.
3. Catheter Care: Sterile dressing changes q72h (or per policy), chlorhexidine scrub, securement, monitor for CLABSI signs.
4. Skin Integrity: Assess insertion site, prevent pressure injury from tubing.
5. Psychosocial Support: Education, coping, body image, family involvement.
6. Medication Administration: Insulin (often in TPN), electrolytes, vitamins, trace elements – verify compatibility.
7. Complication Surveillance: Hyperglycemia, refeeding syndrome, line infection, thrombosis, liver dysfunction (cholestasis).
8. Metabolic Bone: Long‑term → monitor vitamin D, DEXA.

Multidisciplinary

RDN adjusts formula; pharmacist verifies stability; MD manages line access; nurse coordinates 24/7.