Renal Nutrition Therapy & Services

Hemodialysis Nurse FAQs

Common Questions & Answers for Hemodialysis Nurses on NutriRite™ IDPN Therapy

Vancomycin and NutriRite™ IDPN are compatible and can be run together via Y-site administration. Begin Vancomycin infusion in the last hour of dialysis.
That’s ok, we understand things happen. Just look at how much time is left on the machine and subtract 15 minutes.
Iron and NutriRite™ IDPN are not compatible. We recommend to give the iron first; give the line a good flush with saline and then administer the NutriRite™ IDPN.
Press start/stop button on the machine, give the medication, flush with saline, and then press start/stop button to resume therapy.
If it’s the 1st bag then reduce by 50 percent; don’t stop the treatment- lower the rate. The patient needs time to adapt to the amount of protein being infused. We would rather start slow then go too fast and have the patient feel poorly. Notify our pharmacist of the intolerance.
It’s time to troubleshoot: Check and see if anything is clamped. Is the tubing straight and not going against gravity? Try opening and re-threading the tubing. Alcohol swab the tubing as needed.
Nausea, vomiting, diarrhea, flushing, headache, feeling of fullness.
We no longer recommend checking blood sugar pre, mid, and post IDPN infusion. Our bags are low in carbohydrate. However, if your clinic policy is to check blood sugar- follow the clinic policy.
The Vista pump does not have a “rate button”. When you press NO to prime set- the next screen reads: enter rate.
Call the pharmacy and they will send out new bags immediately.
Call pharmacy and they will send tubing immediately.
Throw the bag away. We provide enough bags for the week. If the patient is in hospital, contact the pharmacy and let them know to place the patient on hold.
Time to troubleshoot: Is the tubing straight and not going against gravity? Open the door, re-thread the tubing, close the door and press start.
Check and make sure you have the right tubing. Lipid tubing is labeled lipids and has a blue filter. Tubing with a 1.2 micron filter (blue) must be used with lipid formula.
Yes, it’s already connected. No need to attach a separate filter.
The size: White is for amino acids (0.2 micron) and blue for lipids (1.2 micron).
Go back to the last tolerated rate. You may need to progress slowly to get to the 3rd bag rate or the goal rate. Please inform pharmacy of any intolerance right away.
Confirm oral nutrition is indicated for this patient on the order form. If not, call the pharmacy to enroll the patient for 90 days and they will ship the oral nutrition packets.
Usually under Prosol, Clinisol, IDPN or Amino acids. For every treatment given, you may insert grams of protein and volume in the notes or comments. Hypoalbuminemia is usually the nursing diagnosis that’s chosen.
Every patient is different. Expect to see a slow increase in Albumin over 3-6 months. However, you will likely see improvement in energy level, appetite and overall quality of life sooner. It takes time to replete a depleted patient. (Other factors to consider when evaluating results: Patient may not be getting NutriRite™ IDPN 3x a week, the patient may come late or leave early and not receive the entire treatment, and/or, the patient has other comorbidities/inflammation.)
Every treatment in most cases- check the label on the bag.
Usually in the third week if on the order.
No, but it is recommended to check the most recent level to make sure it is <400.
No, but the amount of protein should be lowered if hepatic encephalopathy is present. Ask to speak with our pharmacist for more information.
No, Patient Care America is responsible for preventative maintenance.
Please give to your biomed person to keep for your records should the State surveyor ask to see it./div>
1% bleach and wipe in between patient use.