A nurse is assessing a client who is taking aspirin and reports having tinnitus. Which of the following medications should the nurse expect to administer?

A. "TPN has a low risk of complications.": Total parenteral nutrition carries significant risks, including infection, metabolic imbalances, and liver dysfunction. It is not considered low risk.

B. "TPN will be administered through a peripheral IV in your arm.": TPN is typically administered through a central venous catheter because its high osmolarity can damage peripheral veins. Using a peripheral IV is not standard practice for long-term TPN.

C. "TPN may increase the risk of aspiration.": Aspiration risk is associated with enteral feeding through the gastrointestinal tract, not with TPN, which bypasses the digestive system entirely.

D. "TPN will provide nutrition without going through the digestive tract.": TPN delivers nutrients directly into the bloodstream, bypassing the gastrointestinal tract. This is an essential point for clients to understand regarding how TPN supports nutrition when oral or enteral feeding is not possible.

Rationale for Correct Choices:

• Losartan: Losartan is an angiotensin II receptor blocker (ARB) used to lower blood pressure by relaxing blood vessels and reducing vascular resistance which is especially important for clients with high blood pressure.
• Moexipril: Moexipril is an angiotensin-converting enzyme (ACE) inhibitor that reduces blood pressure by blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor.
• Metformin: Metformin is a first-line oral medication for type 2 diabetes. It decreases hepatic glucose production and improves insulin sensitivity in peripheral tissues. It is commonly prescribed for elevated fasting blood glucose and HbA1c.
• Liraglutide: Liraglutide is a GLP-1 receptor agonist that enhances glucose-dependent insulin secretion, slows gastric emptying, and promotes satiety. It is used to improve glycemic control and can aid in weight management in type 2 diabetes.

Rationale for Incorrect Choices:

• Misoprostol: Misoprostol is a prostaglandin analog primarily used to prevent gastric ulcers in patients taking NSAIDs and to induce labor in obstetrics. It does not have a role in blood pressure management.
• Mesalamine: Mesalamine is used to treat inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, and has no effect on blood glucose levels.