PAEA Surgery End Of Rotation (EOR) Practice Exam

Which intervention requires central access when enteral feeding is not possible for more than 7 days?

1. Peripheral nutrition

2. TPN - total peripheral nutrition

3. Supplemental IV fluids

4. Dietary changes

The correct answer is: TPN - total peripheral nutrition

Total Parenteral Nutrition (TPN) is the correct intervention that requires central access when enteral feeding is not possible for more than 7 days. In TPN, nutrients are delivered directly into the bloodstream through a central venous catheter. This method is necessary for patients who cannot receive adequate nutrition via the gastrointestinal tract due to conditions such as bowel obstructions, pancreatitis, or severe malabsorption syndromes. The use of central access for TPN is crucial because it allows for the administration of a concentrated solution of glucose, amino acids, and lipids, which can be highly osmolar. These concentrated solutions can cause irritation and thrombosis if infused through peripheral veins, which are not suitable for long-term use. Central access enables safe and effective delivery of these essential nutrients over an extended period, ensuring that the patient's nutritional needs are met while minimizing complications associated with peripheral administration. In contrast, peripheral nutrition typically refers to the use of a peripheral intravenous line for delivering less concentrated nutrient solutions and is not adequate for long durations when enteral feeding is contraindicated. Supplemental IV fluids serve to maintain hydration but do not provide the comprehensive nutritional support that TPN offers. Dietary changes, while beneficial in some cases, do not address the need for ongoing