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Heart rhythm change • Redness or drainage from catheter site • Shortness of breath The layout

catheter positioned in the superior vena cava (SVC) proximal to the right atrium of the heart

cardiac arrhythmias, and ileus, whereas lower amounts of magnesium may be needed for those with renal impairment or for those receiving other sources of magnesium. Refer to the Appendix for monitoring and repletion strategies. For 3-in-1 PN solutions, 40the combination of magnesium and calcium must

catheter or peripheral line, as this will impact the PN prescription. PN with osmolarity greater than 900 mOsm/L can only be provided via a central venous catheter.4 (Refer to Chapter 2 for additional information on vascular access devices.) Most facilities will have guidelines, policies

catheter-related infections. 77Intestinal rehabilitation (may decrease risk) Minimize PN dependency by optimizing nutrient absorption through pharmacology and dietary interventions to increase intestinal absorptive capacity. Medications Eliminate hepatotoxic medications. Other Consider evaluating for non-PN etiologies, such as hepatitis, malignancy, alcohol use disorder, polysubstance

heart failure, diabetes, or pulmonary dysfunction) guides the development of a 3comprehensive nutrition care plan. Confirmation of seriously altered or absent GI tract function may be obtained from intake and output reports, results of an EN trial, radiology (eg, CT scan or x-ray) or surgery reports