A nurse is assisting in the care plan for a patient with widespread herpes zoster lesions. What actions should the nurse include in the plan?

Choice A rationale

Intermittent abdominal pain is not typically associated with total parenteral nutrition (TPN) or burn injuries.

Choice B rationale

Increased serum glucose levels can occur with TPN due to the high glucose content of the solution. This should be monitored closely, especially in patients with burns, who may have altered glucose metabolism.

Choice C rationale

Absent bowel sounds are not typically associated with TPN or burn injuries.

Choice D rationale

Decreased calcium levels are not typically associated with TPN or burn injuries.

Choice A rationale

Fever is not typically a sign of fluid overload. It’s more commonly associated with a transfusion reaction, which could indicate an immune response to the transfused blood.

Choice B rationale

Dyspnea, or difficulty breathing, can be a sign of fluid overload. When the body has too much fluid, it can put pressure on the lungs, making it harder to breathe.

Choice C rationale

Pruritus, or itching, is not typically a sign of fluid overload. It may be a sign of an allergic reaction to the transfusion.

Choice D rationale

Bradycardia, or a slow heart rate, is not typically a sign of fluid overload. In fact, tachycardia, or a fast heart rate, is more common as the heart works harder to pump the excess fluid.