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 A,D,B,C

Explanation

A. Clear liquid. Clear liquids are the first step in advancing the diet after a period of nothing by mouth (NPO). They are easy to digest and help prevent dehydration.
D. Full liquid. Full liquids are the next step after clear liquids and include liquids and foods that are smooth and easily poured or formed into a liquid at room or body temperature. Examples
include milk, yogurt, and cream-based soups.

B. Pureed. Pureed foods are soft and smooth, requiring minimal chewing. They are often recommended for individuals who have difficulty swallowing or have undergone oral or facial surgery.
C. Mechanical soft. Mechanical soft foods are semi-solid and easily mashed or broken down with a fork. They are suitable for individuals with difficulty chewing or swallowing but can tolerate more texture than pureed foods.

Correct Answer is ["539"]

Explanation

6 ounces of apple juice = 177 mL (1 ounce = 29.57 mL)
1 cup of water = 240 mL (1 cup = 240 mL)
1 cup of soup = 240 mL
6 ounces of tea = 177 mL
12 ounces of carbonated beverage = 355 mL

Total intake: 177 + 240 + 240 + 177 + 355 = 1189 mL

Total output:

Voided at 0830 = 250 mL
Vomitus at 1300 = 150 mL
Voided at 1400 = 250 mL

Total output: 250 + 150 + 250 = 650 mL

Fluid balance: Total intake - Total output = 1189 - 650 = 539 mL

Therefore, the client's current fluid balance is 539 mL.

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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

Naxlex Comprehensive Predictor Exams

A client who has been NPO has a new prescription to progress the diet as tolerated. In which sequence should the nurse progress the client's diet? (Arrange from first action on top to last on the bottom.)

Correct Answer is A,D,B,C

Explanation

Correct Answer is ["539"]

Explanation

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