Application of Nursing Process Procedure

Assessment
- Complete physical assessment and client history
- Assess weight and take a weight history
- Identify and condition that would affect TPN (renal or cardiac disease)
- Assess nutritional needs of clients who are unable to ingest nutrients normally.
- Identify the caloric intake necessary to promote positive nitrogen balance, tissue repair, and growth
- Observe for correct additives in each hyper alimentation bottle.
- Check lable of solution with physician’s orders
- Check rate of infusion on physician’s order
- Check rate of infusion on physician’s order
- Assess ability of client to understand instructions during the procedure.
- Ensure potency of the central venous line following the insertion
- Observe catheter insertion site for signs of infection, thromboblebities, or possible infiltration.
- Inspect dressing over central line to ensure a dry, non contaminated dressing.

Planning/Objective Setting
- To provide a nitrogen source for clients unable to ingest protein normally.
- To provide adequate calories for clients unable to tolerate oral feedings.
- To provide nutrients for clients requiring by pass of the gastrointestinal tract.
- To provide increased calories where regular IV solutions are insufficient.
- To prevent or correct a deficiency of essential fatty acids.
- To provide a contamination free mode of delivering the hyper alimentation solution

Implementation
- Assisting with catheter insertion
- Maintaining central vein Infusions
- Changing parentral hyper alimentation Dressing and Tubing
- Maintaining Hyper alimentation for children

Evaluation/Expected Outcome
- Catheter is place correctly with no infiltration.
- Solution is infused as prescribed flow rate and tolerated by patient
- Dressing remains dry and in fact during interval between changes.
- Insertion site remains free of infection and inflammation sepsis does not occur.
- Client receives nutrients necessary for tissue repair and sustenance.