Parenteral nutrition (PN) therapy

Transcription

1 Parenteral nutrition (PN) therapy Nutrition Nurse Specialists Information for Patients i University Hospitals of Leicester NHS Trust

2 Introduction This leaflet aims to tell you about your intravenous feed and the effects it may have on your body and how to look after the feed and the equipment. If you have any other concerns that are not addressed here please speak to a member of your nutrition team. What is parenteral nutrition (PN)? Parenteral nutrition (PN) is a way of providing all the nutrition you need when your gut is not available or is not working. What is in PN? It contains water, energy, vitamins, and minerals that are normally provided in your food. They are made up into a milky fluid and come in a large drip bag. How much should I have? The amount of water and nutrients in the bag will be carefully calculated to match your individual needs. 2

3 How does this go into me? A plastic tube called a central venous catheter is inserted through the skin into a large vein in your neck, chest or upper arm. It is called a central line because the tip of the tube is close to your heart in the centre of your body. How does it work? As the nutrient solution is dripped into the vein the pumping of your heart takes it all around your body in your blood. Your cells can then take the food and fluid they require as it travels in your blood stream. This bypasses your gut and goes directly into your blood stream. Is this as good as eating? Yes, the bag will provide you with a balanced diet. Will I feel hungry or thirsty? PN satisfies the appetite in most patients. Your mouth may feel dry; cleaning your teeth and having regular mouthwashes will help. 3

4 May I eat and drink? This depends on your circumstances. Complete rest of your digestive system may be necessary, or you may be allowed small amounts of water. You should be guided by your doctor. How many hours is the drip attached for? Generally, in hospital, you will be fed for 24 hours a day, 7 days a week. This allows your doctor to give you the maximum feed in a slow and safe manner and also reduces the likelihood of any infections getting into your line, which is changed once a day. Will I be able to move around? Yes, as much as your condition allows. Your PN will hang on a mobile stand and the pump will have a battery facility lasting several hours. You should be able to walk around with this. Will I be able to have a bath or shower? Yes but it is sensible to not put too much water onto your dressing and if the dressing is wet you must ask a nurse to change this as soon as you are out of the bathroom. 4

5 What happens to my bowels? Mucus, cells and bacteria mean you still have bowel movements despite taking no food by mouth. The PN goes straight into the blood stream and will not have any effect on your bowel however the increased fluid intake can occasionally make your bowel movements a little looser. How do you monitor this? The nurses will weigh you twice a week and you will have your blood sugar, blood pressure and pulse checked regularly. You will have daily blood tests for the first week or so, this may continue if you are unwell, however, if you are stable we will reduce these to two to three times a week. The nurses will keep a strict note of all the fluid you take in and the fluid which comes out so we can look after you more effectively. Why do I need so many tests? The blood tests help the nutrition team decide what to put into your individually made bag in order to feed you more effectively. It is not safe to give PN without checking some of the essential salt levels in your blood. If we are not able to take your blood the PN may have to stop until we are able to get the results of these tests. 5

6 How long will I have to have this? PN can be used for several months or for life. Most patients stay on between 14 days to one month. Please discuss this with your doctors when they visit you and they should be able to give you a time scale. Who are the nutrition team? The nutrition team consists of a specialist nurse, a senior dietician, a senior pharmacist and a doctor as required. They will visit most working days and your feed will be ordered as normal over the weekends and bank holidays if they are not there. For more information contact the nutrition nurse specialist Leicester Royal Infirmary Leicester General Hospital Community Home Enteral Nutrition Service: Other sources of information This site is intended for all nutrition patients and their carers as well as healthcare professionals and the general public and of course, PINNT members, both adults and children. The Leicestershire Nutrition and Dietetic Service website provides further information regarding the Home Enteral Nutrition Service 6

7 Any questions? If you have any questions write them down and bring them to the hospital to remind you what to ask when you speak to your consultant or nurse specialist. 7

8 If you would like this information in another language or format, please contact the Service Equality Manager on Haddaad rabto warqadan oo turjuman oo ku duuban cajalad ama qoraal ah fadlan la xiriir, Maamulaha Adeegga Sinaanta Eĝer bu broşürün (kitapçıĝın) yazılı veya kasetli açıklamasını isterseniz lütfen servis müdürüne telefonundan ulaşabilirsiniz. Produced: October 2010 Review: October 2012 (Dennis) KR??0??-1010