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. The consumption of fruit and/or vegetables should total between 4 to 6 servings. The DASH diet actually recommends 4 to 5 servings each of fruits and vegetables per day, not combined. This statement indicates an incomplete understanding.
B. The consumption of dairy-based products should be eliminated from the diet. The DASH diet does not eliminate dairy products; instead, it recommends 2 to 3 servings of low-fat or fat-free dairy products daily.
C. The consumption of protein products should come from lean meats, nuts, and dried beans.

This is correct. The DASH diet emphasizes lean protein sources such as poultry, fish, nuts, and legumes, and limits red meat.
D. The consumption of bread products should be gluten-free. The DASH diet does not

specifically recommend gluten-free products unless the individual has a gluten intolerance or celiac disease. The focus is on whole grains rather than gluten-free.

A. Urinary ketones. B. Serum protein. C. Serum osmolarity. D. Capillary glucose.

Correct Answer is D

Explanation

A. Urinary ketones are incorrect. Urinary ketones are more relevant in clients with diabetes or starvation states, but monitoring capillary glucose is more important in clients on TPN, as they may experience fluctuations in blood sugar levels.
B. Serum protein is incorrect. While serum protein is important for assessing nutritional status, capillary glucose is more critical for monitoring during TPN administration.
C. Serum osmolarity is incorrect. Serum osmolarity is important to assess fluid and electrolyte balance, but capillary glucose is more frequently monitored due to the risk of hyperglycemia in TPN patients.
D. Capillary glucose is correct. TPN contains high levels of glucose, and monitoring capillary glucose is critical to detect hyperglycemia and adjust the infusion rate or insulin therapy accordingly.

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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

The nurse is reviewing a nutrition plan with a client newly diagnosed with hypertension. Which statement by the client indicates an understanding of the Dietary Approaches to Stop Hypertension (DASH) diet?

Correct Answer is C

Explanation

While caring for a client receiving total parenteral nutrition (TPN), it is most important for the nurse to monitor which of the client's laboratory values?

Correct Answer is D

Explanation

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