COMPLICATIONS OF PARENTERAL NUTRITION

Complications Possible Cause Signs and Symptoms Nursing Intervention

Air embolism • Opened catheter Apprehension • Clamp the catheter when
system Chest Pain not in use.
• Disconnected
isconnected IV Dyspnea • Place the client of left side
tubings Hypotension lying position with head
• Air on IV tubings Rapid and weak pulse lower than the feet.
Respiratory distress • Administer oxygen
Loud churning sound over • Instruct client in the
pericardium Valsalva manuever for
tubing and cap changes..
Hyperglycemia • Clients receiving Coma • Slowed infusion rate
solution too quickly Confusion • Administration of Regular
• Not enough insulin Diaphoresis Insulin as prescribed
• infection Elevated blood glucose • Monitor blood glucose
level (≥200mg/dL)
≥200mg/dL) levels
Excessive thirst • Use aseptic technique
Fatigue
Kussmaul’s Respiration
Restlessness
Weakness

Hypervolemia • Excessive fluid Bounding pulse • Slow or stop IV infusion

administration Crackles on lungs • Restrict IV fluids
• Administration of fluid Headache • Administer diuretics
rapidly Increase blood pressure • Use dialysis in extreme
• Renal dysfunction Jugular vein distension cases
• Heart failure Weight gain • Monitor intake and output
• Hepatic failure • Weigh patient daily
• Administer fluid via
infusion pump
• Assesss client’s history for
risk of hypervolemia

Hypoglycemia • Parenteral Nutrition Anxiety • Monitor blood glucose

abruptly discontinued Diaphoresis • Administration of
• Too much insulin Low blood pressure intravenous dextrose
administration Weakness • Gradual decrease of PN
Shakiness prior to discontinue
• Infuse 10% dextrose at the
same rate of PN

Infection • Poor aseptic technique Chills • Removal of catheter

• Catheter contamination Fever • Obtain blood cultures
• Contamination of Elevated WBC • Administer antibiotic as
solution Erythema or discharges at prescribed
insertion site • Use strict aseptic
technique
• Monitor vital signs
• Change site dressing,
solution and tubing as
specified by agency policy
• Assess IV site for signs of
infection
Pneumothorax • Incorrect pl
placement of Absence of breath sounds • Monitor for sign of
catheter on affected side Pneumothorax
Chest or shoulder pain • Obtain chest X ray after
Sudden shortness of breath insertion of catheter
Tachycardia placement is verified.
Cyanosis

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