Nursing problems in total parenteral nutrition

Aim: The aim of the study was to estimate nursing problems associated with total parenteral nutrition.
Material and methods: The study was conducted in 2006 among 20 patients with total parenteral nutrition. Patients were assessed during five consecutive days. Laboratory study results and medical records were assessed. On the basis of individual nursing cards provision of nursing care was assessed in the following aspects: state of oral mucosa, state of respiratory system, physical activity and psychological state. For the purpose of results assessment method of severity level index and Student’s t-test were used.
Results: In the group of twenty patients 12 had restricted mobility in the aspect of independent change of position in bed; the other patients needed help. Only one patient had no pressure ulcers; the other patients had pressure ulcers. All patients had pathological changes in the oral cavity and respiratory system and had psychological problems. Electrolyte abnormalities were observed, for example low level of Cl in 95% of patients (p<0.0001), low level of Ca in 75% of patients (p<0.02) and hyperglycaemia (p<0.0006).
Conclusions: Among parenterally feeding patients the following problems were observed: presence of pressure ulcers, stomatitis, respiratory tract diseases and worsening of psychological state. Electrolyte and glycaemic disturbances were also observed.