A nurse is about to replace a nearly depleted container of total parenteral nutrition (TPN) for a patient, but discovers a delay in the delivery of the new TPN solution from the pharmacy.
Which solution should the nurse administer until the next TPN solution is available?

0.9% sodium chloride.

Dextrose 10% in water.

3% sodium chloride.

Lactated Ringer’s.

Answer and Explanation

The Correct Answer is B

Choice A rationale

0.9% sodium chloride, also known as normal saline, is an isotonic solution that is commonly used for hydration and to replace lost fluids. However, it does not provide any calories or nutrients, which are necessary for patients receiving TPN1.

Choice B rationale

Dextrose 10% in water (D10W) is the recommended solution to administer until the next TPN solution is available. This is a hypertonic fluid that provides dextrose to the patient, helping to maintain their blood glucose levels and reducing the risk of hypoglycemia.

Choice C rationale

3% sodium chloride is a hypertonic saline solution that is typically used to treat patients with severe hyponatremia (low sodium levels). It is not suitable as a replacement for TPN as it does not provide the necessary nutrients and can lead to hypernatremia (high sodium levels) if used inappropriately.

Choice D rationale

Lactated Ringer’s solution is an isotonic solution that is commonly used for fluid resuscitation in patients with significant fluid loss. While it does contain multiple electrolytes that mimic those found in plasma, it does not provide any calories or nutrients, making it unsuitable as a replacement for TPN1.

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Correct Answer is B

Explanation

Choice A rationale

While observing the patient’s respiratory status is important in all patient care, it is not the priority action in this case. The patient’s decreased level of consciousness and inability to swallow increase the risk of aspiration, which can lead to respiratory complications.

Choice B rationale

Elevating the head of the patient’s bed 30° to 45° is the priority action. A patient who has a decreased level of consciousness and an inability to swallow is at risk for aspiration. Lying down also increases this risk. The priority action by the nurse is to keep the head of the bed elevated to promote gastric emptying and reduce the risk of aspiration.

Choice C rationale

Monitoring intake and output every 8 hours is important for assessing the patient’s hydration status and nutritional needs. However, it is not the priority action in this case. The risk of aspiration due to the patient’s decreased level of consciousness and inability to swallow takes precedence.

Choice D rationale

Checking residual volume every 4 to 6 hours is a standard practice when administering continuous enteral feedings through a gastrostomy tube. It helps to ensure that the patient is tolerating the feedings and not at risk for aspiration due to high gastric residuals. However, in this case, the priority is to prevent aspiration by elevating the head of the bed.

A. Fresh vegetables B. Red meat C. Dairy products D. Caffeinated beverages

Correct Answer is D

Explanation

Choice A rationale

Fresh vegetables are generally not considered bladder irritants. They are part of a healthy diet and do not typically cause bladder irritation.

Choice B rationale

Red meat is not typically associated with bladder irritation. While some individuals may have specific dietary sensitivities, red meat is not commonly known to irritate the bladder.

Choice C rationale

Dairy products are not typically associated with bladder irritation. However, some individuals may have lactose intolerance or other specific sensitivities to dairy products.

Choice D rationale

Caffeinated beverages can irritate the bladder. Caffeine is a diuretic, which means it can increase urine production and potentially lead to bladder irritation.

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A nurse is about to replace a nearly depleted container of total parenteral nutrition (TPN) for a patient, but discovers a delay in the delivery of the new TPN solution from the pharmacy. Which solution should the nurse administer until the next TPN solution is available?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is developing a care plan for a patient with a decreased level of consciousness who is receiving continuous enteral feedings through a gastrostomy tube due to an inability to swallow.What should be the nurse’s priority action?

Correct Answer is B

Explanation

A nurse is teaching a client who has urinary incontinence about avoiding foods and beverages that can cause bladder irritation.Which of the following foods and beverages is a bladder irritant?

Correct Answer is D

Explanation

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A nurse is about to replace a nearly depleted container of total parenteral nutrition (TPN) for a patient, but discovers a delay in the delivery of the new TPN solution from the pharmacy.
Which solution should the nurse administer until the next TPN solution is available?