A nurse is caring for a client who has a prescription for total parental nutrition (TPN).
Which of the following routes of administration should the nurse use?
Midline catheter.
Central venous access device.
Subcutaneous.
Intraosseous.
The Correct Answer is B
This is because TPN solutions are concentrated and can cause thrombosis of peripheral veins, so a central venous catheter is usually required. TPN should only be used when the intestine is unavailable or unable to absorb nutrients.
Choice A is wrong because a midline catheter is a type of peripheral catheter that can only be used for solutions with low or moderate osmolarity, not for TPN.
Choice C is wrong because subcutaneous administration is not a route for delivering TPN, which requires intravenous infusion.
Choice D is wrong because intraosseous administration is an emergency route for delivering fluids and drugs when intravenous access is not available, not for TPN.
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Related Questions
Correct Answer is B
Explanation
This will help reduce swelling and discomfort caused by the infiltration of fluid into the tissues. Elevating the extremity also promotes venous return and prevents further fluid accumulation.
Choice A is wrong because applying pressure to the IV site can increase the risk of tissue damage and infection.
Pressure can also obstruct blood flow and cause thrombophlebitis.
Choice C is wrong because slowing the infusion rate will not stop the infiltration of fluid into the tissues.
Slowing the infusion rate can also delay the delivery of medication or fluid to the client.
Choice D is wrong because flushing the IV catheter can worsen the infiltration of fluid into the tissues.
Flushing the IV catheter can also introduce air or bacteria into the bloodstream and cause complications.
Normal ranges for peripheral IV infusion are dependent on the type and volume of fluid, the size and location of the catheter, and the condition of the client. Generally, peripheral IV infusion rates should not exceed 100 mL/hr for adults and 60 mL/hr for children.
Correct Answer is D
Explanation
The most appropriate action for the nurse to take in this situation is:
d. Apply a warm, moist compress.
Here's why the other options are not recommended:
- a. Initiate a new IV distal to the initial site:This is not the first course of action. While starting a new IV might be necessary eventually, it's crucial to address the issue at the current site first.
- b. Slow the IV solution rate:Slowing the rate doesn't directly address the coolness and edema, which indicate potential infiltration or extravasation.
- c. Maintain the extremity below the level of the heart:This action would actually worsen the edema by promoting fluid accumulation at the site.
Applying a warm, moist compress can help promote absorption of any leaked fluid and improve circulation at the site. However, it's important to remember that this is just one step in the process. The nurse should also:
- Stop the IV infusion.
- Assess the extent of the infiltration or extravasation.
- Document the findings.
- Elevate the affected extremity.
- Consult with a physician for further instructions and potential treatment.
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