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Deficiencies are prevalent in HPN patients, especially in light of product shortages and inevitable non-adherance. Providers vigalent surveillance & supplementation is worthwhile, as it has potential to impact outcomes. Falk A. Evaluating the effectiveness of a micronutrient assessment tool for long...

Causes of anemia Microcytic: Nutritional deficiencies- Iron, copper or zinc Anemia of chronic inflammation Hemaglobinopathy - thalassemias Sideroblastic anemias Normocytic: Acute GI bleeding Hemolytic - Hypersplenism, infection, trauma, G6PD, sickle cell, spherocytosis Chronic renal insufficiency...

Indications for HPN Hospitalization: - Fever 100.4 - Dehydration - Lack of working vascular access Failure with outpatient management (unable to provide HPN safely in community) Indications for liver failure hospitalization: - Acute altered mental status - Acute GI bleeding - Fever, concern for...

PN cycling Infants at around 2 months-old can often tolerate cycling. Taper on by starting with one half the hourly rate for 30 to 60 minutes. Taper off by decreasing the hourly rate by one one for 30 to 60 minutes, then decrease the hourly rate by one fourth for 30 minutes.

Short bowel syndrome (Definition): Condition resulting from Intestinal malabsorption related to massive surgical bowel resection -- ranges from mild intestinal dysfunction responsive dietary and pharmacological measures to severe intestinal failure requiring 100% parenteral support. Most important...

Caregiver flushes the central venous catheter and they feel an unusual amount resistance to flushing. The catheter has the following appearance (see photo below). They call HPN on-call for advice. What is the first thing you should advise family to do? A. Offer reassurance if central line is not...

A family notices there is bleeding at the central line site (see photo below). What is this? A. Tumor B. Bacterial Infection C. Granulation tissue D. Psoriasis E. Pustule Click here for answer Go to previous question Go to next question

Family notices there is bleeding at the central line site (see photo below). What is this? A. Tumor B. Bacterial Infection C. Granulation tissue D. Psoriasis E. Pustule The correct answer is c. Granulation tissue. This is granulation tissue at the exit site. It is made of connective tissue with...

Patient complains of pain and burning during central line dressing changes with chlorhexadine. Central line exit site has the following appearance (see below). What is the proposed treatment plan? A. Use betadine cleanse for central line dressing changes for chemical burn. B. Prescribe IV...

Patient had redness near central line exit site. The central line was inserted 1 year ago. The patient has no fevers or chills. What is the next step? A. Remove suture. B. Remove central line. C. Prescribe broad spectrum antibiotics. D. Prescribe steroids. E. Reassurance The correct answer is a...