A client reports experiencing numbness and ngling in the extremies. Which of the client's serum laboratory values should the praccal nurse (PN) priorize reporng to the healthcare provider?

a) Collect fingerstick glucose levels.Correct

Collecting fingerstick glucose levels is the most important intervention for the PN to implement for a client who is receiving TPN. TPN is a method of feeding that bypasses the gastrointestinal tract and provides all the nutritional needs of the body through a vein. TPN contains a high concentration of glucose, which can cause hyperglycemia or fluctuations in blood sugar levels. Therefore, it is essential to monitor the client's glucose levels frequently and adjust the infusion rate or insulin administration accordingly.

b) Implement bleeding precautions.

Implementing bleeding precautions is not the most important intervention for the PN to implement for a client who is receiving TPN. Bleeding precautions are measures to prevent or minimize bleeding in clients who have a high risk of hemorrhage due to conditions such as thrombocytopenia, coagulopathy, or anticoagulant therapy. TPN does not directly increase the risk of bleeding, although it may affect the liver function and clotting factors in some cases². Therefore, bleeding precautions are not a priority for a client who is receiving TPN.

c) Obtain daily weights.

Obtaining daily weights is not the most important intervention for the PN to implement for a client who is receiving TPN. Obtaining daily weights is a way to monitor the client's fluid balance, nutritional status, and response to therapy. TPN can cause fluid overload, dehydration, or electrolyte imbalances in some cases²⁵. Therefore, obtaining daily weights is important, but not as important as monitoring glucose levels.

d) Check urine for albumin.

Checking urine for albumin is not the most important intervention for the PN to implement for a client who is receiving TPN. Checking urine for albumin is a way to detect proteinuria, which is an indicator of kidney damage or disease. TPN does not directly cause kidney problems, although it may affect the renal function and urine output in some cases². Therefore, checking urine for albumin is not a priority for a client who is receiving TPN.

Choice A reason: Administering an antipyretic is not the next action that the nurse should initiate because it does not address the priority problem of potential brain damage or death caused by meningococcal meningitis, which is a bacterial infection of the meninges that can rapidly progress to septic shock or disseminated intravascular coagulation.

Choice B reason: Decreasing environmental stimuli is not the next action that the nurse should initiate because it does not address the priority problem of potential brain damage or death caused by meningococcal meningitis, which can impair the function of the central nervous system and cause increased intracranial pressure, seizures, coma, or cranial nerve palsies.

Choice C reason: Assessing the cranial nerves is the next action that the nurse should initiate because it can provide vital information about the extent and severity of brain involvement caused by meningococcal meningitis, which can affect any or all of the 12 pairs of cranial nerves that control sensory and motor functions of the head and neck.

Choice D reason: Completing a vascular assessment is not the next action that the nurse should initiate because it does not address the priority problem of potential brain damage or death caused by meningococcal meningitis, which can cause inflammation and damage of blood vessels in various parts of the body, leading to ischemia, necrosis, or gangrenE.