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When weight loss or lack of appetite becomes severe, nutrition can be given right into a vein. This allows you to get the protein, vitamins, and other nutrients your body needs for energy. This special nutrition solution can be given into an implanted port, a tunneled catheter, or any other long-term catheter placed in a large vein. Nutrition like this may be needed if you cannot tolerate food by mouth or your bowel needs to rest.
You will need to learn to care for the catheter and learn to give yourself the nutrients. Your nutrition solution will be given on a schedule that best fits your needs for care and the amount of calories required. The healthcare provider or dietitian will explain the schedule that is best for you. The choices of schedules are:
Continuous. The amount of solution for the day will be given slowly over the 24-hour period.
Cyclic. The amount of solution for the day will be given over a 12-hour period.
You will also need to learn about some of the problems that can happen with nutrition solutions and what to report to your healthcare provider.
The parental feeding is important in giving you the nutrients you need. When care is taken to give the solution safely, many problems can be avoided. Such as:
High blood sugar. Your blood sugar level may become high as a result of the amount of sugar in the solution. You will need to have blood tests to monitor this level as often as the healthcare provider thinks is necessary, usually 2 to 3 times per week.
Special medicine called insulin may be added to your nutrition solution.
The type of solution may need to be changed.
Low blood sugar. Your blood sugar may become low if there is an interruption in the infusion of the nutrient solution:
Infuse the solution at the rate you have been instructed to use.
Do not stop or interrupt the solution without calling the healthcare provider first.
Blood tests may be done to measure your blood sugar levels.
Infection. Clean the catheter daily as follows or as instructed by your healthcare provider or nurse:
Use only sterile techniques when changing the dressing of the catheter or hooking up the solution.
Remove old dressing, being careful not to pull the tube or dislodge the needle. Put on the new dressing as instructed by your healthcare provider.
Check for redness, soreness, or drainage every time you change the dressing. Call your healthcare provider if you see any signs of concern.
Your solution should be clear and free of floating material. Before using the solution, gently squeeze the bag to make certain there are no leaks. Do not use the nutrient solution if the bag leaks or if the solution looks cloudy or has particles in it. Call the healthcare provider or pharmacist for instructions.
Tips for management include the following:
Have blood tests for sugar level drawn as directed.
Should low blood sugar happen, try to drink one or two glasses of juice or eat several pieces of hard candy if approved by your healthcare provider. Symptoms should resolve quickly. The symptoms are sweating, nervousness, shaking of hands, hunger, weakness, irritability, numbness of the tongue or lips, and headache.
Self-administer insulin as you have been instructed, or call your healthcare provider immediately if symptoms of high blood sugar happen: dry, hot, flushed skin; thirst; fatigue; frequent urination; upset stomach.
Fever of 100.4°F (38ºC) or 1°F above your normal or daily temperature, unless otherwise advised by your healthcare provider, based on your age, medical condition, and other symptoms.
Do not adjust the rate of nutrition solution or stop your therapy without talking with your healthcare provider. Parenteral nutrition is stopped slowly and under medical supervision. The amount is decreased a little at a time until you can take food by mouth or use other nutritional support methods like enteral tube feedings.
If you have any management questions, call your healthcare provider.
Follow-up suggestions include:
Discuss any difficulties with solution infusion with your healthcare provider or dietitian.
Notify your healthcare provider right away if any of the following happens:
Fever that lasts more than 24 to 48 hours
Fever of 100.4°F (38ºC) or 1°F above your normal or daily temperature, unless otherwise advised by your healthcare provider, based on your age, medical condition, and other symptoms
Tenderness, drainage, or redness at catheter site
Swelling of your neck or arm
High blood sugar: dry, hot, flushed skin; thirst; fatigue; frequent urination; upset stomach
Low blood sugar: sweating, nervousness, shaking of hands, hunger, weakness, irritability, numbness of tongue or lips, headache
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