Symptom and description
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 doctor, nurse, 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 occur with nutrition solutions and what to report to your doctor.
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 doctor thinks is necessary, usually two to three times per week.
Special medication 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 with the rate as you have been instructed to use.
Do not stop or interrupt the solution without calling the doctor first.
Blood tests may be done to measure your blood sugar levels.
Infection. Clean the catheter daily as follows or as instructed by your doctor or nurse:
Use only sterile technique when changing the dressing of the catheter or hooking up the solution.
Remove old dressing, being careful not to pull tube or dislodge needle. Put on the new dressing as instructed by your doctor or nurse.
Check for redness, soreness, or drainage every time you change the dressing. Call your doctor or nurse if you see any signs of concern.
Do not use the nutrient solution if it looks cloudy or has particles in it. Call the doctor or pharmacist for instructions.
Have blood tests for sugar level drawn as directed.
Should low blood sugar occur, try to drink one or two glasses of juice or eat several pieces of hard candy if approved by your doctor. 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 doctor immediately if symptoms of high blood sugar occur: dry, hot, flushed skin; thirst; fatigue; frequent urination; upset stomach.
Call doctor for any temperature of 100.5 degrees F or higher.
Do not adjust rate of nutrition solution or stop your therapy without talking with your doctor. 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.
Discuss any difficulties with solution infusion with your doctor, nurse, or dietitian.
Notify your caregiver if any of the following occur:
Temperature of 100.5 degrees F or higher
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