For catheter insertion for TPN, which access site should a nurse plan for?

When planning for catheter insertion for total parenteral nutrition (TPN), the right subclavian vein is the preferred access site due to its suitable anatomical positioning and low risk of complications. This vein offers a direct and stable route to the central venous system, facilitating the delivery of TPN solutions, which are often hyperosmolar and require central access to avoid complications such as phlebitis or venous irritation that can occur with peripheral veins.

The subclavian vein allows for longer-term access, which is essential for TPN, as patients often require this form of nutrition for an extended period. Its location also reduces the risk of complications seen with other access sites, such as accidental arterial puncture or infection, particularly when sterile techniques are observed during insertion.

Other potential access sites, while usable, are less favorable. The left antecubital vein is a peripheral option and may not be suitable for long-term TPN administration due to the risk of phlebitis. The right femoral artery, while capable of providing access, is not an appropriate site for TPN delivery as it is an arterial site and could pose significant risks. The left arm radial artery is similarly contraindicated for TPN, as it is also arterial and would