Question 13. You are consulted as the HPN expert by the inpatient cardiology team to facilitate discharge for a 3 year-old female with a history of heart transplant for hypoplastic left heart syndrome was admitted for new onset 3-week history of vomiting, diarrhea and weight loss. Diagnostic laboratory and imaging studies are still pending. Patient started parenteral nutrition yesterday. GI is planning on pursuing an outpatient evaluation. Patient is stable from a cardiac perspective for discharge. What is your next step?
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Informally consult with family to introduce program, do not leave note in chart.
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Collaborate with medical, GI and nutrition team to facilitate completion of diagnostic work-up of feeding intolerance prior to formal HPN consultation.
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Initiate HPN formal consult immediately for prompt discharge.
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Refuse HPN consult, because HPN not indicated.
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Request team meeting to review plan of care including HPN before agreeing to formal HPN consult.
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