Monitoring Guidelines for TPN

- Monitor for signs of infection or sepsis at the insertion site, which is the most common complication of TPN
- Weigh client daily – obsorb for fluid gain or loss. Weight gain may indicate fluid overload rather than increased nutritional gain.
- Monitor electrolyte and protein levels daily in the beginning of treatment. Magnesium and calcium imbalance may occur.
- Monitor serum glucose levels observing for hyperglycemia (thirsty, polyuria)
- Assess blood urea nitrogen and creatinine levels – increases may indicate excess amino acid intake.
- Check liver function test results – abnormal value may indicate an excess of lipids or problems in protein or glucose metabolism.

Study questions:
• Describe the electrolyte composition of the body
• Define electrolyte.
• Mention the manifestation of fluid disturbance
• Describe causes of acid base imbalance
• Mention two to apply procedures for ensuring nutritional maintenance
• State procedure for NG tube insertion.
• Describe conditions in which NGT feeding is indicated.