What is Total Parenteral Nutrition (TPN) 
                  Hyperalimentation?
    • TPN or Hyperalimentation is the administration of concentrated glucose & 
      amino acid solutions via a central or large diameter peripheral vein.
    • TPN therapy is necessary when the GI tract cannot be used or is not used 
      to meet the Patient nutritional needs.
    • TPN solutions may contain 20%-60% glucose and 3.5% to 10% protein (in 
      the form of amino acids) in addition to various amounts of electrolytes, 
      vitamins, minerals, & trace elements.
    • These solutions can be modified, depending on the presence of organ 
      system impairment and/or the specific nutritional needs of the Patient.
    • To provide necessary amounts of fat and the fat soluble vitamins (A, D, E, 
      and K), intralipids are often administered 2-3x a week along with TPN 
      (monitor triglyceride levels)
    • TPN is often used in hospital, long term care, and subacute care, but is also 
      frequently used in the home-care setting.
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      What is Total Parenteral Nutrition (TPN) 
                    Hyperalimentation?
     TPN or Hyperalimentation is the IV infusion of a 
       nutritionally, complete formula, including 
        – amino acids (protein/nitrogen)
        – dextrose (carbohydrate/glucose)
        – fat emulsions (fatty acids)
        – vitamins
        – electrolytes
        – minerals
        – trace elements
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    Why Use TPN? (Purpose of TPN)
    • Promote wound healing
    • Avoid malnutrition
    • Examples: severe burns, sepsis, cardiac 
      conditions, trauma, liver failure, GI conditions 
      impairing absorption, anorexia nervosa
    • Nutrition through the GI tract is best & should 
      be used when the Patient GIT is functional 
      before initiating parental nutrition
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             Candidates for TPN
    Candidates for TPN
    • Patient unable to take nutrition orally or 
      enterally 
    • Who are at risk of malnutrition because of 
      actual or anticipated prolonged inability to 
      ingest, digest, or absorb nutrients
    • Patient who are severely injured 
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             Expected Outcomes
    • Expected Outcomes
    1. Patient will achieve/maintain ideal body weight
    2. Patient will achieve/maintain fluid & electrolyte balance
    3. Patient will maintain serum glucose levels at less than 
        200mg 
    4. Patient will remain free of local & systemic infections
                   TPN Expected Outcomes
    1. Patient will achieve/maintain ideal body weight
    Wt gain is usually between 1 & 2 pounds per week
    Wt is an indicator of how well the Patient is doing nutritionally & 
        determines fluid volume
    A wt gain greater than 1 pound per day indicates fluid retention
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