A patient is being transitioned from total parenteral nutrition delivered through a central venous catheter to oral feedings. Which of the following would most likely occur with this patient?

Question

1. provide peripheral parenteral nutrition for several days and progress as tolerated
2. pull the central venous catheter and provide oral meals as tolerated
3. pull the central venous catheter and insert a nasogastric tube for enteral feedings
4. cap the central venous catheter; provide peripheral parenteral nutrition and enteral feedings through a postpyloric tube

Answer 1

1

Rationale: Peripheral parenteral nutrition is infused into smaller, peripheral veins, and is often used for short-term nutrition support, or as a supplement during transitional phases to enteral or oral nutrition routes. The patient will need a transition from total parenteral nutrition prior to going directly to oral feedings. Providing peripheral parenteral nutrition for several days with progressing as tolerated is the appropriate method for this patient. The central venous catheter should not be pulled and the patient moved immediately to oral feedings or to enteral feedings through a nasogastric tube. The central venous access device can be capped however if it is not known if the patient needs both peripheral parenteral nutrition and enteral feedings through a postpyloric tube.