Administering Lipids

Administering Lipids

Equipment
■ Intravenous lipid solution (not refrigerated).
■ Special tubing (infusion set) for lipids.
■ If a filter is used, it must be a 1.2-micron filter.
■ Be Safe! Infusion set must be without plasticizers (DEHP) and should be labeled to that effect.
■ Needleless cannula (if using a split-septum needleless connector that requires it).
■ 70% isopropyl alcohol or CHG-containing pads.
■ Procedure gloves.
■ Time tape.
■ Infusion pump.
■ I&O record.

Assessment
■ Check the patient record for:
■ Anemia.
■ Coagulation disorders.
■ Abnormal liver, pancreatic, or respiratory function.
■ Be sure the prescriber is aware of these factors; they do not necessarily contraindicate giving the PN.
■ Assess for:
■ Rash.
■ Eczema.
■ Dry, scaly skin.
■ Poor wound healing.
■ Sparse hair.
■ Check a peripheral IV site for erythema, infiltration, and patency.
■ Check a central venous access site for erythema or other signs of infection.
■ Take baseline VS just before infusing the lipids. (Note: Not all guidelines require this action.)

Post-Procedure Reassessment
■ If ordered, monitor serum lipids 4 hours after discontinuing the
infusion.
■ Monitor IV site for:
■ Patency.
■ Infection, inflammation, and infiltration.
■ Monitor for:
■ Symptoms of fat emboli.
■ Allergic reactions.
■ Lipid intolerance.

Key Points
■ Gather and prepare the equipment.
■ Position the patient supine.
■ Be certain lipids are not cold.
■ Examine bottle for a layer of froth or separation into fat globules or layers.
■ Label the bottle with patient’s name, room number, date, time, rate, and stop/start times. Label tubing with date and time.
■ Be Safe! Compare the lipids bottle to the patient’s wrist band and the original prescription. Have a coworker verify.
■ Use new tubing for each bottle of lipids.
■ Be Safe! Carefully identify the correct IV line and port for the infusion. Trace the tubing from the bag back to the patient. If infusing simultaneously with PN, use a separate port below the PN filter.
■ Take VS before infusing, then every 10 minutes for 30 minutes, and observe for side effects.
■ Place the primed tubing in the pump, thoroughly scrub the catheter injection port or the Luer-Lok threads and hub with an antiseptic swab, attach the lipids tubing, and lock/secure the tubing connection.
■ Begin the infusion slowly. If no reactions occur after 30 minutes, adjust to the prescribed rate.
■ Complete the infusion within 20 hours.
■ Be Smart! When lipids are infused with PN, the lipid infusion must be completed within 12 hours.
■ When the infusion is finished, discard the bottle and IV administration set. They cannot be reused.

Documentation
■ A special form may be used for documenting lipids and PN administration.
■ Document:
■ Bottle number, date and time hung, volume, type of fluid, and rate of delivery.
■ Status of dressing, and date and time of dressing or tubing change (if performed).
■ Patient’s tolerance of the procedure and any problems encountered.
■ Pre- and postadministration assessment data and blood tests, if any.
■ Condition of the IV site.
■ Weight.
■ I&O.