A client is receiving total parenteral nutrition (TPN) via a subclavian central line, and the solution bag is nearly empty. The next bag of TPN is not available from the pharmacy. Which action should the nurse implement until the fluid arrives?

Slow the infusion rate and catch up the rate when the next TPN solution arrives.

Flush the central line with a heparin solution and cap the subclavian access.

Start 1,000 mL of 0.9% sodium chloride and monitor the serum glucose levels.

Follow the TPN with a 10% dextrose solution at the current rate of infusion.

Answer and Explanation

The Correct Answer is C

A. Slow the infusion rate and catch up the rate when the next TPN solution arrives. Slowing the

infusion rate may not provide adequate nutrition to the client, and catching up the rate later could lead to complications such as hyperglycemia or hypoglycemia.
B.   Flush the central line with a heparin solution and cap the subclavian access. Flushing the central line with heparin and capping the access would not provide the client with nutrition and could increase the risk of line occlusion.

C.   Start 1,000 mL of 0.9% sodium chloride and monitor the serum glucose levels. Starting 0.9% sodium chloride (normal saline) provides hydration and helps maintain electrolyte balance until the next bag of TPN is available. Monitoring serum glucose levels is essential to ensure that the client's glucose levels remain within the target range.
D.   Follow the TPN with a 10% dextrose solution at the current rate of infusion. Administering a 10% dextrose solution could lead to hyperglycemia, especially if the client does not require additional glucose. It is important to maintain appropriate glucose levels while awaiting the next bag of TPN.

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Correct Answer is C

Explanation

A. Oatmeal with honey, applesauce, and pear nectar. While oatmeal may be suitable for some

individuals with dysphagia, adding honey and pear nectar increases the risk of aspiration due to their liquid consistency. Applesauce may also pose a risk depending on the client's swallowing ability.
B. Pancakes with syrup, link sausage, and orange juice. This meal contains several items that may be difficult for someone with dysphagia to swallow safely, including pancakes with syrup and link sausage. Orange juice may also pose a risk of aspiration.
C. An oral nutritional supplement. Oral nutritional supplements are designed for individuals with dysphagia who have difficulty swallowing solid foods. They provide essential nutrients in a
liquid form that is easier to swallow and can help maintain adequate nutrition in clients with dysphagia.
D. Scrambled eggs, bacon, toast, milk, and coffee. This meal contains several items that may be difficult for someone with dysphagia to swallow safely, including scrambled eggs and toast. Milk and coffee may also pose a risk of aspiration.

A. Fruits and vegetables. B. Complete proteins. C. Calcium-rich dairy products. D. High potassium foods.

Correct Answer is A

Explanation

A. Fruits and vegetables. Snacking on fruits and vegetables provides fiber, vitamins, and

minerals while being lower in calories, making them suitable choices for an adolescent with a high BMI who may be looking to manage their weight.
B. Complete proteins. While complete proteins are important for overall nutrition, they may not be the best choice for after-school snacks, especially if the client is trying to manage their
weight, as they can be higher in calories.

C. Calcium-rich dairy products. While dairy products are important for calcium intake, they can also be higher in calories and fat. Depending on the client's overall dietary intake, they may not be the best choice for snacks if weight management is a concern.
D. High potassium foods. While potassium-rich foods are important for overall health, they may not be the best choice for after-school snacks specifically. Focusing on lower-calorie, nutrient- dense options like fruits and vegetables is more appropriate for an adolescent with a high BMI who may be trying to manage their weight.

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A client is receiving total parenteral nutrition (TPN) via a subclavian central line, and the solution bag is nearly empty. The next bag of TPN is not available from the pharmacy. Which action should the nurse implement until the fluid arrives?

Nursing Test Bank

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