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 B

Explanation

A. Taco salad, refried beans, low-fat ice cream, and coffee. This meal may contain high levels of sodium, particularly in the taco salad and refried beans, which could exacerbate the client's
elevated serum sodium level.

B. Canned cream of mushroom soup, tuna salad, and water. This meal likely has a lower sodium content compared to the other options, as long as the canned cream of mushroom soup is chosen with a low-sodium option. Tuna salad can be prepared with low-sodium ingredients, and water is sodium-free.
C. Chicken salad on toast, fruit-flavored yogurt, and iced tea. Chicken salad and fruit-flavored yogurt can contain hidden sources of sodium, especially if they are commercially prepared or contain added sauces or flavorings. Iced tea may also contain sodium, depending on how it is prepared.
D. Bacon, lettuce, and tomato sandwich, grapes, and skim milk. Bacon is typically high in sodium, which would not be advisable for someone with elevated serum sodium levels. Skim milk and grapes are generally low in sodium, but the sandwich could significantly contribute to the client's sodium intake.

A. Advise the client to include aerobic exercise along with dietary changes. B. Emphasize the need to reduce caloric intake, rather than increasing it. C. Instruct the client to also increase the daily intake of dietary fiber. D. Encourage the client to continue these changes in a dietary plan. E. None F. None

Correct Answer is D

Explanation

Rationale for A: Advising the client to include aerobic exercise could be beneficial as it may help in weight management and overall health. However, it does not directly address the dietary concerns associated with hyperthyroidism.
Rationale for B: Reducing caloric intake is generally not recommended for hyperthyroidism as the condition often leads to weight loss and increased metabolism; therefore, patients may require more calories to maintain a healthy weight.
Rationale for C: Increasing dietary fiber is beneficial for general health and can aid digestion, but it is not the primary dietary change needed for managing hyperthyroidism.
Rationale for D: Encouraging the client to continue increasing protein and caloric intake is appropriate, as hyperthyroidism can cause weight loss and muscle wasting. Adequate protein and caloric intake can help mitigate these effects.

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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 has a serum sodium level of 155 mEq/L (155 mmol/L). The nurse should encourage the client to make which selection from the lunch menu? Reference Range: Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]

Correct Answer is B

Explanation

In reviewing the dietary teaching for a young adult client with hyperthyroidism, the nurse learns that the client has increased the intake of protein and calories. Which action should the nurse take?

Correct Answer is D

Explanation

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