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This is a Discussion post from a student. All I need to do is to give a response base on this post. also I need references.

Total parenteral nutrition for the critically ill diabetic patient can minimize malnutrition if monitored closely and is adjusted to the individual’s needs. Diabetes is a chronic illness where insulin is either not produced (type 1) or the body has developed resistance to insulin (type 2) to carry glucose inside the body cells. Consequently, the glucose in the blood is excessive causing hyperglycemia. The body needs glucose for energy and due to the inadequate uptake by the cells, the body starts to use fat and protein as energy sources. A person with undiagnosed or poorly controlled diabetes can see a weight reduction because of the fat consumption leading to muscle mass wasting. Type 2 Diabetes is highly associated with obesity. The excess consumption of carbohydrates and sugars increases the glucose in the blood. Patients with diabetes need to be on very strict diets and have to be vigilant to avoid spikes and drops in their blood sugar. They need to know the percentage of each food group to consume and how to spread their meals throughout the day. When a patient is hospitalized, routine becomes disturbed, and other illnesses and medications can affect nutrition.

Total parenteral nutrition is a designated method to nourish the patient when enteral nutrition is not possible. A major reason is when the GI tract is nonfunctional or there is a GI illness. Examples include malabsorption, bowel obstruction, paralytic ileus, intestinal ischemia, radiation, severe colitis, excessive GI bleed and intractable vomiting or diarrhea. A benefit of total parenteral nutrition is that it is administered via a vein usually a central line straight to the bloodstream regardless of gut function and can be used for long term. Another benefit of parenteral nutrition is that the formula composition can be individualized to meet a patient’s nutritional needs. Total parenteral nutrition can achieve 100% nutrition with the adequate macronutrients and micronutrient. Insulin can also be added to better control glucose.

Some risks to total parenteral nutrition include infection, hyperglycemia and overnutrition (Oshima & Pichard, 2015). Infection may occur because parenteral nutrition uses invasive procedure to access a vein to introduce the nutrition. Hyperglycemia may occur if the nutrients in the formula are not balanced or adjusted to the individual, especially when insulin is needed. Overnutrition can easily happen if the nutrition is not closely monitored, this is why a registered dietician working together with the multidiciplinary team can be a great resource to overlook the patient’s nutrition.

Here’s the Required textbook

Nutrition and Diet Therapy for Nurses, Sheila Tucker, Vera Dauffenback.

ISBN13:978-0131722163;

ISBN10:013172216

Two references are required: one from the course textbook.One from a peer-reviewed NURSING journal less than 5 years old. National professional, governmental, or educational organizations (.org, .gov, or.edu) be used as supplemental references.

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Must use the textbook as Reference