The TPN and PPN policy previously gave nurses the ability to order and start D10W if parenteral nutrition was interrupted for any reason. However, the updated policy now states that nurses should contact Pharmacy if a TPN is interrupted, for initiation of an appropriate fluid in the interim (if not already ordered by the provider). While short interruptions (< 30 minutes) typically require very little, if any, intervention, longer interruptions may require initiation of a dextrose-containing fluid to prevent hypoglycemia, especially if the patient has received an intermediate or long acting insulin. See page 10 in the Adult TPN Guide for additional information.

 

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