I.V. ROUNDS: Administering parenteral nutrition with other I.V. drugs

February 2005 
Volume 35  Number 2
Pages 26 - 26
  PDF Version Available!


  • Minimizing infection risks

  • The line on other I.V. medications

  • Beware of incompatibility


    PARENTERAL NUTRITION solutions can be challenging to infuse because they increase the risk of infection and aren't compatible with many other I.V. medications. In this article, I'll discuss how you can avoid problems.

    Minimizing infection risks

    Because of their high osmolarity, parenteral nutrition solutions must be infused through a central venous catheter (CVC). Unfortunately, this raises the risk of catheter-related infections. For patients receiving long-term infusions, the catheter hub is the most frequent portal of entry for pathogens. Whenever you change administration sets or needleless connectors, you manipulate the catheter hub, giving pathogens an opportunity to enter the patient's bloodstream.

    To reduce that risk, take precautions during each change of set or connector. Clean the catheter hub with an antiseptic product (such as an alcohol pad) to remove dried blood, drug precipitate, and skin oils from the twist-lock threads. Avoid touching the sterile ends of the tubing or contaminating them in any other way. If you're attaching administration sets to a needleless connector, thoroughly disinfect the surface of the connector with an antiseptic solution.

    Change administration sets every 24 hours if the patient is receiving a nutrition formula that contains a lipid emulsion or if the lipid emulsion is piggybacked into the primary administration set infusing the parenteral nutrition formula. Lipid emulsions are an excellent medium for microbial growth.

    If the patient isn't receiving a lipid emulsion, change the administration set every 72 hours. If you're using a needleless connector, change it at the same time you change the administration set.

    The line on other I.V. medications

    Dedicate ...

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