Parenteral Feeding

Symptom and Description

When weight loss or lack of appetite becomes severe, nutrition can be given by vein. This allows you to get the protein, vitamins, and other nutrients your body needs for energy. This special nutrition solution can be given into an implanted port, a tunneled catheter, or any other long-term catheter placed in a large vein. Nutrition like this may be needed if you cannot tolerate food by mouth or the bowel need to rest.

Learning Needs

You will need to learn to care for the catheter and learn to give yourself the nutrients. Your nutrition solution will be given on a schedule that best fits your needs for care and amount of calories required. The doctor, nurse, or dietitian will explain the schedule that is best for you. The choices of schedules are:

  • Continuous: The amount of solution for the day will be given slowly over the 24-hour period.

  • Cyclic: The amount of solution for the day will be given over a 12-hour period.

You will also need to learn about some of the problems that can occur with nutrition solutions and what to report to your doctor.

Preventing Problems

The parental feeding is important in giving you the nutrients you need. When care is taken to give the solution safely, many problems can be avoided. Such as:

1. High blood sugar: Your blood sugar level may become high as a result of the amount of sugar in the solution. You will need to have blood tests to monitor this level as often as the doctor thinks is necessary, usually two to three times per week.

  • Special medication called insulin may be added to your nutrition solution.

  • The type of solution may need to be changed.

2. Low blood sugar: Your blood sugar will become low if there is an interruption in the infusion of the nutrient solution.

  • Infuse the solution with the rate as you have been instructed to use.

  • Do not stop or interrupt the solution without calling the doctor first.

  • Blood tests will be done to measure your blood sugar levels.

3. Infection: Clean the catheter daily as follows or as instructed by your doctor or nurse:

  • Use only sterile technique when changing the dressing of the catheter or hooking up the solution.

  • Wash hands.

  • Remove old dressing, being careful not to pull tube or dislodge needle.

  • Begin cleaning next to catheter with alcohol , working out ward to push bacteria away from catheter.

  • Clean same area a second time with povidone iodine (Betadine), or with the swabs you have been instructed to use, working outward to push bacteria away from catheter.

  • Clean catheter with povidone iodine where it exits from your body.

  • Check for redness, soreness, or drainage.

  • Place new gauze to cover catheter or needle, and tape.

  • Do not use the nutrient solution if it looks cloudy or has particles in it. Call the doctor or pharmacist for instructions.

Management

  • Have blood tests for sugar level drawn as directed.

  • Should low blood sugar occur, try to drink one or two glasses of juice or eat several pieces of hard candy. Symptoms should resolve quickly. The symptoms are sweating; nervousness; shaking of hands; hunger; weakness; irritability; numbness of tongue or lips; headache.

  • Self-administer insulin as you have been instructed or call doctor immediately if symptoms of high blood sugar occur: dry, hot flushed skin; thirst; fatigue; frequent urination; upset stomach.

  • Call doctor for any temperature of 100. 5 F (38 C) or higher.

  • Do not adjust rate of nutrition solution without talking with your doctor.

Follow-up

1. Discuss any difficulties with solution infusion with your doctor, nurse, or dietitian.

2. Notify your caregiver if any of the following occur:

  • Temperature of 100. 5 F or higher

  • Chills

  • Tenderness, redness at catheter site

  • Swelling of neck or arm

  • High blood sugar: dry, hot, flushed skin; thirst; fatigue; frequent urination; upset stomach

  • Low blood sugar: sweating; nervousness; shaking of hands; hunger; weakness; irritability; numbness of tongue or lips; headache

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