A home health nurse is assessing a client receiving TPN infusion for malabsorption after extensive bowel surgery. What finding is most important for the nurse to report to the health care provider?

Low-grade fever

Fatigue

Anorexia

Hypoactive bowel sounds

Answer and Explanation

The Correct Answer is A

A. Low-grade fever: A low-grade fever could indicate an infection or other complications related to TPN or bowel surgery, and it is crucial to report this to the healthcare provider.
B. Fatigue: While fatigue is a common symptom, it is less urgent compared to a potential infection.
C. Anorexia: Anorexia is a concern but is not as immediate as a fever.
D. Hypoactive bowel sounds: This is expected after extensive bowel surgery and may not be as urgent as signs of infection.

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Correct Answer is C

Explanation

A. Abdomen soft, surgical dressing has scant amount of old drainage: A soft abdomen and minimal old drainage from the surgical dressing are expected findings postoperatively. They do not indicate an immediate concern that requires prompt action.
B. Client ambulating with minimal assistance, complaints of occasional nausea: Ambulation and occasional nausea are common and generally expected postoperatively. These findings do not require urgent collaboration with the healthcare provider.
C. Crackles bilaterally in bases of lungs, has incisional pain: Crackles in the lungs can indicate fluid accumulation or atelectasis, which may lead to pneumonia or other respiratory complications. This finding, especially combined with recent surgery, requires prompt evaluation and intervention.
D. Temperature 99.4°F (37.4°C), pulse 100 bpm, bowel sounds present: A slightly elevated temperature and increased pulse are common after surgery. The presence of bowel sounds is a positive sign indicating the return of gastrointestinal function. These findings are not immediately concerning.

A. Intraosseous line B. Intrathecal catheter C. Peripheral intravenous line D. Subcutaneous implantable port E. Subcutaneous implantable port

Correct Answer is D

Explanation

A. Intraosseous line: Intraosseous lines are used for emergency situations when peripheral access is not available, and are not suitable for long-term chemotherapy administration due to the risk of complications and discomfort.
B. Intrathecal catheter: Intrathecal catheters are used for delivering medication directly into the spinal canal. They are not suitable for systemic chemotherapy administration, which requires vascular access.
C. Peripheral intravenous line: Peripheral intravenous lines are typically used for short-term treatments. They are not ideal for long-term chemotherapy because they need frequent replacement, and the veins can become damaged from prolonged use of chemotherapeutic agents.
D. Subcutaneous implantable port: A subcutaneous implantable port is the best option for long-term chemotherapy. It is implanted under the skin, reducing the risk of infection, and provides a stable and reliable access point for repeated treatments over several months.

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A home health nurse is assessing a client receiving TPN infusion for malabsorption after extensive bowel surgery. What finding is most important for the nurse to report to the health care provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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