Nausea is a common side effect of TPN, often caused by the type of feed or medications administered. Here’s a breakdown of specific factors:

Types of Feed
* Hyperosmolar feeds: These concentrated feeds can irritate the gut lining, leading to nausea.
* Rapid infusion: Infusing TPN too quickly can also cause nausea and vomiting.
* Nutrient imbalances: An imbalance of nutrients, such as excessive glucose or amino acids, can trigger nausea.
* Lipid emulsions: While essential for providing essential fatty acids, lipid emulsions can sometimes cause nausea, especially if infused too rapidly or if the patient is sensitive to them.

Medications
* Opioids: Commonly used for pain management, opioids can slow down the digestive system and cause nausea.
* Antibiotics: Some antibiotics can irritate the gut lining and lead to nausea.
* Antiemetics: Ironically, medications used to prevent nausea (antiemetics) can sometimes themselves cause nausea.

Other Factors
* Psychological factors: Stress, anxiety, and fear can contribute to nausea.
* Underlying medical conditions: Certain conditions, such as Gastroparesis or liver disease, can increase the risk of nausea on TPN.

To minimize nausea on TPN:

Always speak to your nutrition team regarding Nausea
* Adjust the type of feed: If hyperosmolar feeds are causing nausea, consider using a more diluted or isotonic formula. ‘This can only be done by your nutrition team‘.
* Slow down the infusion rate: Gradually increase the infusion rate to allow the body to adjust.
* Monitor nutrient levels: Regularly check nutrient levels to ensure they are balanced.
* Consider alternative medications: If opioids or antibiotics are causing nausea, discuss alternatives with your healthcare provider.
* Manage psychological factors: Relaxation techniques, such as deep breathing or mindfulness, can help reduce stress and anxiety.
* Address underlying medical conditions: Treating underlying conditions can help alleviate nausea.
If nausea persists despite these measures, consult with your healthcare provider to discuss additional strategies or potential adjustments to your TPN regimen.