what is preferred salt to add to TPN mixtures
sodium phosphate
what trace elements are possible aluminum contaminants
arsenic, aluminum, chromium, zinc, manganese, coppe
What product sources are primary concern for aluminum toxicity
potassium phosphate
calcium gluconate
heparin
albumin
What two additives are not a major source of aluminum contamination
Regular insulin
ILE
Only 2 medications compatible with TPN
famotidine (H2 receptor antagonist)
insulin
What central line access is preserved for renal pts who may need HD
subclavian
most common skin anti-sepsis cleaning agent for CVAD
chlorhexidine
What two infections are recommended to remove central access
fungal infections
S. Aureus
If a pt with central access has purulence, what kind of infection is it usually?
exit site infection
What is used for a catheter exit site if there is not purulence?
topical antimicronial agent
What disease state is high risk for thrombus formation
ovarian cancer
HCl best used to clearing occlusions from acidic precipitations of
calcium-phosphate
vancomycin
Bicarb or NaOH best used to clearing occlusions from basic precipitations of
oxacillin
phenytoin
what is the etiology of a thrombotic catheter occlusion
fibrin sheath formation
where should you obtain blood glucose level 30-1hr after discontinuing PN
capillary
what trace element deficiency can cause cardiomyopathy if not included on long term PN
selenium
what is max GIR for diabetic pts with hyperglycemia
4mg/kg/min
increase urine Ca excretion is seen with
high protein administration
cyclic TPN infusion
low PHOS
chronic metabolic acidosis
decreased Ca can contribute to deficiency of what micronutrient
magnesium
catheter related thrombosis caused by fibrin build up within blood vessels adhering to CVC is called:
mural thrombus
If pt presents with cyanosis of the face, neck, shoulders, and arm; what complication is this characterized by?
superior vena cava syndrome
What type of device complication is characterized by pain, swelling, erythema
tunnel infection
What type of device complication is characterized by chest pain, earache, jaw pain, swelling of the arm, shoulder, neck, or face or leaking at the exit or insertion site
thrombus
which drugs interfere with folate metabolism?
methotrexate
sulfasalazine
