Symptom and description
When weight loss or the inability to eat becomes severe, nutrition can be given right
into a vein. This allows you to get the water, fat, protein, vitamins, and other nutrients
your body needs for energy. This special nutrition solution can be given into an implanted
port, a tunneled tube (catheter), or any other long-term catheter placed in a large
vein. Nutrition like this may be needed if you can’t handle taking 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.
You may want to have a family member or friend learn how to do these things, too. Your
nutrition solution will be given on a schedule that best fits your needs for care
and the amount of calories required. The healthcare provider or dietitian will explain
the schedule that is best for you. The choices of schedules are:
You will also need to learn about some of the problems that can happen with nutrition
solutions and what to report to your healthcare provider.
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 prevented. These are some
of the problems that can develop:
Blood sugar changes. You will need to have your blood sugar checked often. This is
especially important when you first start getting parenteral nutrition. You may be
taught to do this at home. You will be taught to watch for signs of high and low blood
sugar levels. Contact your healthcare provider if you have signs of blood sugar problems:
High blood sugar. Your blood sugar level may go up due to the amount of sugar in the
solution. Symptoms of high blood sugar include dry, hot, flushed skin. They also include
thirst, severe tiredness (fatigue), frequent urination, and upset stomach.
Low blood sugar. Your blood sugar may become low if there is an interruption in the
infusion of the nutrient solution. The symptoms are sweating, nervousness, shaking
of hands, hunger, weakness, irritability, numb tongue or lips, and headache.
Infuse the solution at the rate you have been instructed to use.
Should low blood sugar happen, try to eat several pieces of hard candy if approved
by your healthcare provider. Symptoms should go away quickly.
Don’t stop or interrupt the solution without calling your healthcare provider first.
Infection. Clean the catheter daily and any time it gets wet as follows or as instructed
by your healthcare provider or nurse:
Wash your hands.
Use only sterile methods when changing the dressing of the catheter, flushing it, or
hooking up the solution. You will be taught how to do this. Make sure you understand
exactly what to do.
Remove the old dressing, being very careful not to pull the tube or dislodge the needle.
Put on the new dressing as instructed by your healthcare provider. Call your healthcare provider
if the catheter seems to be coming out or the part outside your body seems to have
changed in length.
Check for redness, soreness, or drainage every time you change the dressing. Call
your healthcare provider if you see any signs of concern.
Use new, sterile syringes and tubing every time.
Your solution should be clear and free of floating material. Before using the solution,
gently squeeze the bag to be sure there are no leaks. Don't use the nutrient solution
if the bag leaks or if the solution looks cloudy or has particles in it. Call your
healthcare provider or pharmacist for instructions.
Other catheter problems. Your healthcare provider or nurse will teach you how to use
your catheter safely and troubleshoot problems. Here are some of the more serious
problems you should know about. If any of these happen, call your provider right away.
Catheter damage. This can be caused by using a lot of force to flush it or clamping
in the wrong place or at the same place every time. Talk with to your nurse about
what you should do if the catheter gets a hole or leak. You may be give a special
scissors-like clamp to put between the leak and the place the catheter goes into your
body until you get medical help.
Air embolism. This is when a lot of air goes into the catheter and into your blood
stream. This can be prevented. You will be taught how to "flush" the tubing to get out the
air out before hooking it up to your catheter. There may be special filters along
the tubing to trap air, too. You will also be taught how to use the clamps and safely
change the caps.
Blocked catheter. If you can’t flush it the catheter (and you're sure the clamps are
open) it may be blocked. Don’t try to forcefully flush it. There are special medicines
that can be used to open it.
Blood clots. These are possible, and the vein the catheter is in is can become red,
irritated, and painful. These can be prevented with regular, safe catheter care.
Tips for management include the following:
Follow all the instructions on how to use your catheter and give feedings very carefully.
Call your healthcare provider or nurse any time you have questions or concerns.
Have blood tests for sugar level drawn as directed.
Don't adjust the rate of nutrition solution or stop your therapy without talking with
your healthcare provider. 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 such as enteral tube feedings.
If you have any management questions, call your healthcare provider.
Follow-up suggestions include:
Be sure you know what other problems you should watch for, and know how to get help
any time. , including after Know what number to call after office hours, on weekends,
and on holidays.