American Association of Critical-Care Nurses (AACN) Certification Practice Test

What is the preferred method of nutritional support when the gut cannot be used and the anticipated time frame is greater than two weeks?

1. Duodenal tube

2. Central vein (TPN)

3. NG tube

4. Esterostomal tube (PEG)

The correct answer is: Central vein (TPN)

When the gastrointestinal tract is unable to be utilized for nutritional support for an extended period, particularly when the anticipated time frame exceeds two weeks, the preferred method is total parenteral nutrition (TPN) administered via a central vein. This approach allows for the direct delivery of essential nutrients, including carbohydrates, proteins, fats, vitamins, and minerals, into the bloodstream, bypassing the gastrointestinal system entirely. TPN is crucial in cases where enteral feeding (nutrition via the gut) is not possible due to severe gastrointestinal dysfunction, obstruction, or conditions requiring complete bowel rest. It minimizes the risk of malnutrition during prolonged periods without enteral access. Additionally, TPN can be tailored to meet the specific nutritional needs of the patient, taking into account their metabolic demands and fluid status. In contrast, the other methods mentioned do not provide the same level of nutritional efficacy for long durations. For instance, a duodenal tube or a nasogastric (NG) tube may be suitable for short-term feedings, typically less than two weeks. However, they rely on the functionality of the gastrointestinal tract and are not designed for long-term use in patients who cannot utilize their intestines effectively. An esophagostomy or PEG tube may be employed