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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?

A.

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

B.

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

C.

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

D.

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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Related Questions

Correct Answer is C

Explanation

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.

Correct Answer is D

Explanation

A. Cherries and cranberries. These fruits are generally low in potassium and are safe for people with chronic kidney disease (CKD).
B. Apples and blueberries. These fruits are also low in potassium and safe for CKD patients.

C. Carrots and green beans. These vegetables are low in potassium and safe for CKD patients.

D. Avocados and bananas. Both avocados and bananas are high in potassium. Clients with stage 4 CKD need to limit their intake of high-potassium foods to prevent hyperkalemia, which can be dangerous given their impaired kidney function.

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