A client is receiving total parenteral nutrition (TPN). The nurse enters the room and discovers that the container only has 15 minutes of solution left.
She calls the pharmacy and is told that the next bag will not be available for another hour.
What must the nurse do next?

Choice A rationale

While documenting medications is important for the physician's review, this is not the primary nutritional assessment reason for asking about medications. The focus here is on how medications interact with nutritional status.

Choice B rationale

Assessing for allergic reactions to medications is crucial for patient safety, but it is a separate aspect of medication history and not directly related to the metabolism of nutrients during a nutritional assessment.

Choice C rationale

Certain medications can significantly interfere with the absorption, metabolism, and excretion of various nutrients. For example, some drugs can increase nutrient excretion, decrease appetite, or alter the body's ability to utilize vitamins and minerals, directly impacting nutritional status.

Choice D rationale

While some medications can affect memory and thus the accuracy of a 24-hour food recall, the more direct and critical reason for asking about medications during a nutritional assessment is to identify potential drug-nutrient interactions that affect metabolism.

Choice A rationale

Palpating the tender area first can cause increased pain and muscle guarding, potentially interfering with the subsequent auscultation of bowel sounds. It is important to auscultate before palpation to avoid altering the natural bowel sounds.

Choice B rationale

Examining the tender area last minimizes the client's discomfort and reduces the likelihood of muscle guarding affecting the assessment of other abdominal areas. This systematic approach allows for a more accurate evaluation of non-tender regions before focusing on the area of complaint.

Choice C rationale

Examining the tender area first will likely cause the patient increased discomfort, leading to muscle guarding that can make it difficult to accurately assess other areas of the abdomen. This approach can also make the patient apprehensive and less cooperative for the remainder of the examination.

Choice D rationale

Avoiding palpation of the tender area altogether would result in an incomplete assessment. Palpation is crucial for evaluating tenderness, masses, and organomegaly in the area of the patient's pain. Modifying the order of assessment is preferred over complete avoidance.