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

Sublingual medications are designed to be absorbed directly into the bloodstream through the highly vascular mucous membranes under the tongue. Dissolving it in water and administering it through an NG tube would bypass this route, potentially altering the drug's absorption and effectiveness, as it would then be processed through the gastrointestinal system.

Choice B rationale

Administering the medication under the client's tongue ensures that it is absorbed sublingually, bypassing the gastrointestinal tract. This is the intended route for this medication, allowing for rapid absorption and avoiding potential interactions or degradation in the digestive system. The rich blood supply under the tongue facilitates quick entry into systemic circulation.

Choice C rationale

Requesting an oral formulation might be an option if the sublingual route is absolutely contraindicated, but it doesn't address the immediate situation. Oral medications have different absorption rates and may be unsuitable for a client with an NG tube if they have swallowing difficulties or other gastrointestinal issues.

Choice D rationale

Crushing a sublingual medication and administering it through an NG tube is inappropriate. This alters the intended drug delivery mechanism and could lead to unpredictable absorption, potential blockage of the NG tube, and loss of the medication's intended effect. Sublingual formulations are not designed for enteral administration.

Choice A rationale

Green leafy vegetables are excellent sources of vitamins, minerals, and fiber, which are crucial for overall health during breastfeeding. However, they are not primary sources of complete protein, which contains all nine essential amino acids needed for milk production and maternal tissue repair.

Choice B rationale

Citrus fruits and juices are rich in vitamin C and provide hydration, which are important during breastfeeding. However, they are primarily sources of carbohydrates and micronutrients and do not offer significant amounts of protein necessary for increased protein intake during lactation.

Choice C rationale

White bread, rice, and potatoes are primarily sources of carbohydrates, providing energy. While they contribute to the overall caloric intake needed during breastfeeding, they are low in protein and do not offer the essential amino acids required in higher amounts for milk production and maternal needs.

Choice D rationale

Nuts, turkey breast, and lean meats are excellent sources of complete protein, providing all the essential amino acids required by a breastfeeding mother and her infant. These foods support milk production, tissue repair, and overall nutritional needs during lactation, making them healthy choices for increasing protein intake.