Question

Case Study - Crohn's Disease and TPN Mrs. Reese is a 36-year-old woman who was diagnosed with Crohn's disease two years ago. She was recently admitted to the hospital with an exacerbation of her Crohn's disease. She was severely malnourished and was found to have complete bowel obstruction with multiple adhesions. She is 5' 4" tall and weighs 108 pounds, with a usual weight of 122 lbs. She is scheduled for surgery, and undergoes a small bowel resection to remove the diseased bowel and create a temporary ileostomy. Following surgery, she has a central line catheter placed and is started on total parenteral nutrition with intralipids 1. Calculate this patient's percent of weight loss. Why was this patient started on total parenteral nutrition (TPN) rather than enteral feedings or peripheral parenteral nutrition (PPN)? Click here to enter text. 2. What are some of the complications that occur with intravenous catheters? Click here to enter text. 3. How can the nurse reduce these complications? Click here to enter text. 4. Why is it important for the nurses to start the parenteral feedings slowly and monitor electrolyte levels? Click here to enter text. 5.

Answer 1

1) Patients usual weight =122 lbs

Present weight =108 pounds

Weight loss =14 lbs = 11. 47%

Divide Change in Mass by Initial Mass. To find the percent change, simply multiply this number by 100

Patient’s percent of weight loss =11.47%

2) The patient started on total Parenteral nutrition because patient underwent bowel resection and there is no other source of nutrition the patient is receiving. Besides that to restore the normal digestive system TPN is needed

3) Below are the main complications that occur with intravenous catheters.

Dislodgement- The unintentional removal of a catheter from the vein, or completely out of the skin

Infection- The presence and growth of pathogenic microorganisms having a local or systemic effect

Infiltration/Extravasation-The inadvertent leakage of fluid or medication into the surrounding tissue

Occlusion- The inability to infuse fluids and/or medication through a previously functioning IV catheter

Phlebitis-The inflammation of a vein, due to mechanical, chemical or bacterial irritation