PAEA Surgery End Of Rotation (EOR) Practice Exam

What type of access is required for TPN?

1. Peripheral access

2. Central access

3. Oral access

4. Subcutaneous access

The correct answer is: Central access

Total Parenteral Nutrition (TPN) requires central access because it involves the administration of nutrient solutions directly into the bloodstream, bypassing the digestive system. The solutions used in TPN are hypertonic and can be irritating to the veins. Therefore, central venous access is preferred to ensure that the concentrated nutrients can be delivered safely and effectively. Central access typically involves the use of a central venous catheter placed in larger veins, such as the subclavian or internal jugular veins, allowing for high-volume infusions and long-term nutrition support. This method minimizes the risk of complications such as phlebitis or vein thrombosis, which can occur with peripheral access, especially when administering such concentrated solutions. In contrast, peripheral access may not provide adequate flow rates and can lead to complications when used for prolonged TPN therapy. Oral access is not suitable for TPN, as TPN is specifically designed for patients who cannot receive adequate nutrition through the gastrointestinal tract. Subcutaneous access is also inappropriate for TPN delivery, as this route is typically used for certain medications and not for high-volume nutrient solutions. Thus, central access is the correct and necessary approach for administering TPN.