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Total Parenteral Nutrition (TPN),
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The American Society for Parenteral and Enteral Nutrition:"A.S.P.E.N. is a professional organization whose members are involved in the provision of clinical nutrition therapies, including parenteral and enteral nutrition. Its nearly 6,000 members are physicians, nurses, dietitians, pharmacists, scientists and other allied health professionals."
A.S.P.E.N. 8630 Fenton Street, Suite 412 - Silver Spring, MD 20910 1-800-727- 4567 or 301-587-6315 email address: aspen@nutr.org
http://www.clinnutr.org/


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Pediatric Total Parenteral Nutrition (TPN), NIH Clinical Center Nursing Department:"Note: TPN is usually needed only if the patient cannot receive adequate nutrition via the gut. Consider alternate enteral supplementation if appropriate. Use appropriate worksheet a guide to ordering. Note: There are two different worksheets depending on the child's weight (30 kg or less and more than 30 kg) For "Calculations," multiply patient weight (wt) or total volume of TPN by multiplication factors. Multiplication factors are usual ranges. Note suggestions for first day and maximum amounts. Adjust as needed. Right column corresponds to MIS ordering template Be sure to order an inpatient schedule. Standard for short term TPN is to run over 24 hours. For longer term TPN, seek advice on "short-cycle" TPN. Intralipids (20% Fat Emulsion): Placed as a separate order under "Fat Emulsion." See appropriate TPN Worksheet for suggestions. Seek advice from nutritionist, clinical pharmacy specialist, or pediatric consultant as needed. "
http://www.cc.nih.gov/ccc/pedweb/pedsstaff/tpn.html

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Total Parenteral Nutrition in the Critically Ill Patient, JAMA:"Nutritional support has become a standard of care for hospitalized patients, but whether total parenteral nutrition (TPN) affects morbidity and mortality is unclear."
http://jama.ama-assn.org/issues/v280n23/abs/jce80032.html

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Total Parenteral Nutrition (TPN), MedicineAu:"Total Parenteral Nutrition (TPN) is ordered by the Duty Intensivist. TPN may be administered by Registered Nurses who are accredited to give intravenous medication and have undertaken training to care for CVC sites and lines."
16 Carrington Street (PO Box 519), Lismore, NSW 2480, Australia.
Ph: +61 (0)2 6622 4453 Fax: +61 (0)2 6622 3185
http://www.medicineau.net.au/clinical/ICU/procedures/tpn.html

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Etiology Of Malnutrition In The Cancer Patient, Total Parenteral Nutrition In Cancer Patients, Orthomolecular Oncology:"The etiology of malnutrition is multifactorial, involving secretion of cytokines such as tumor necrosis factor (TNF) by tumor directly or from antigen-antibody allergic response to antineoplastic therapy. Unlike simple starvation, this metabolic response leads to visceral tissue depletion, labelled bypoalbuminemic malnutrition (Harvey et al., 1979). Additional tissue cytokines result in protein wasting, depletion of body fat, and decreased food intake (Fong et al., 1989). The consequence of this cancer cachexia is cell-mediated immune deficiency. Excess morbidity and mortality result from opportunistic infection and failure of wound healing. It is also important to recognize that in some patients specific micronutrient deficiencies, such as iron, calcium, magnesium, or vitamin B12 deficiency can be present even in the absence of weight loss and can be devastating (Blackburn et al., 1977)."
http://www.canceraction.org.gg/tpn.htm

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Total Parenteral Nutrition (TPN), pharmalicensing.com:"Total parenteral nutrition in its complete sense includes the administration of Amino Acids, Fats, Carbohydrates, Minerals and Vitamins. All these elements when given via parenteral route to the patient who "should not", "will not" and "cannot" take food via the oral or the Enteral route. Amino acids play an important role in building up the protein levels of the patient thereby mentioning the proper metabolic activities, building immuno competence and raise the nutritional status of the patient to normal."
http://pharmalicensing.com/licensing/displicopp/488

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Pharmacon:"Pharmacon's nutritional support program is one of the most progressive in the South Florida area. We provide on site and telephone consultation, assisting physicians in prescription formulation and compounding. We also provide the physician with the guidelines for qualification under Medicare and much more. We provide TPN in state-of-the-art portable pumps for the convenience of our patients and of course provide all ancillary products needed from syringes, batteries and dressings to biohazardous waste management."
160 SW 12th Avenue s Suite 101-D s Deerfield Beach, Florida 33442
Telephone 954-725-0222 888-327-2233 FAX 954-725-8811, webmaster@hyperal.com
http://www.hyperal.com/serv01.htm

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Pediatric Parenteral Nutrition, Specialized Clinical Services, Gastroenterology and Nutrition, Department of Pediatrics, School of Medicine, Washington University in St. Louis:"Parenteral nutrition (PN) is a method of supplying nourishment to children unable to eat. The implementation of PN requires decisions about route of infusion, composition of infusate, and the possibility of unusual nutritional needs. The potential benefits and risks for each patient weigh in these decisions. Considered variables or parameters include: child's illness obstacle to enteral feeding: absolute or partial? Temporary or indefinite duration? pre-existing and anticipated nutritional needs quality of life issues: continuous versus cyclic infusion?"
Campus Box 1143, One Brookings Drive, St. Louis, MO 63130
http://peds.wustl.edu/div/gi/spec/tpn/

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Nursing In The Media, Nursingadvocacy.org

  • ER:"Media products under your influence, particularly the NBC/Warner drama "ER," are harming the profession of 2.7 million American nurses by giving the public an inaccurate and inadequate account of what nurses really do to save and improve lives. Research suggests that "ER" strongly and negatively influences the way children view nursing. These products contribute to the nursing shortage, a public health crisis that threatens millions worldwide."

  • NBC's "Passions":"NBC's "Passions" solves nursing shortage: monkeys can do the job! Starting in March 2003 and at least as recently as late August, NBC's campy, supernatural daytime soap opera "Passions" has featured an orangutan named Precious in the role of the private duty nurse of one of its characters--a bold step backwards in the already slow...evolution...of the media's treatment of nurses. more..."

  • "Scrubs" defines nursing:""Scrubs" defines nursing: it's all about shutting up and following physician "orders. " Tonight's episode of NBC's "Scrubs," which purports to teach nurse Carla Espinosa that nursing is all about doing what physicians tell you, is one of the most virulently anti-nurse prime time television episodes the Center has ever seen. more..."
    http://www.nursingadvocacy.org/

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Send comments and mail to Andrew Lopez, RN

Created on July 14, 1999

Last updated by Andrew Lopez, RN on Thursday, May 31, 2007


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