A nurse is caring for a client who has been receiving total parenteral nutrition (TPN) for 1 week. For which of the following findings should the nurse notify the provider?
Serum albumin level 3.9 g/dL
Calcium level 11.5 mg/dL
Output 200 mL more than intake over the past 12 hr
Fasting blood glucose level 105 mg/dL.
The Correct Answer is B
A high calcium level (hypercalcemia) can indicate complications of TPN, such as bone demineralization, renal calculi, or metabolic alkalosis. The nurse should notify the provider of this finding and expect to adjust the TPN formula or administer fluids and diuretics to lower the calcium level. The other options are within normal or expected ranges for a client receiving TPN.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The nurse should expect disequilibrium with movement if the client has impaired function of the vestibulocochlear nerve, as this nerve is responsible for hearing and balance. Deviation of the tongue from midline indicates impairment of the hypoglossal nerve (cranial nerve XII), loss of peripheral vision indicates impairment of the optic nerve (cranial nerve II), and inability to smell indicates impairment of the olfactory nerve (cranial nerve I).
Correct Answer is C
Explanation
This is because the client is experiencing bradycardia, which is a slow heart rate of less than 60/min. Bradycardia can cause decreased cardiac output, which can lead to symptoms such as tremors, fainting, dizziness, chest pain, shortness of breath, and hypotension. Some causes of bradycardia are sinus node dysfunction, atrioventricular block, medication side effects, hypothyroidism, hypothermia, and increased vagal tone.
The nurse should anticipate administering atropine sulfate, which is an anticholinergic drug that blocks the action of the vagus nerve on the heart and increases the heart rate and conduction. Atropine sulfate is the first-line drug for symptomatic bradycardia and can be given intravenously or intramuscularly. The nurse should monitor the client's vital signs, cardiac rhythm, and response to the medication. The nurse should also prepare for other interventions, such as transcutaneous pacing or permanent pacemaker insertion, if atropine sulfate is ineffective or contraindicated.
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