A nurse is caring for a client who has chronic kidney failure. The client received hemodialysis 1 hr ago. The nurse should identify that which of the following findings is a manifestation of a complication related to the procedure?

A. Verify the solution with another RN prior to infusion: TPN is a high-risk therapy that requires verification by two RNs to ensure the correct formulation, preventing medication errors that could lead to severe complications.

B. Monitor serum blood glucose during infusion: TPN contains high concentrations of glucose, increasing the risk of hyperglycemia. Regular blood glucose monitoring helps detect imbalances and allows for timely intervention.

C. Increase the rate of infusion if administration is delayed: Increasing the infusion rate can lead to metabolic complications such as hyperglycemia and fluid overload. If TPN is delayed, the provider should be consulted for adjustments rather than increasing the rate independently.

D. Infuse 0.9% sodium chloride if the solution is not available: If TPN is unavailable, the correct alternative is an infusion of dextrose 10% in water (D10W) to prevent hypoglycemia, not 0.9% sodium chloride, which lacks glucose.

E. Obtain the client's weight daily: Daily weights help monitor fluid balance, nutritional status, and potential complications such as fluid retention or dehydration, ensuring proper TPN management.

A. Hypertension: Elevated blood pressure is not a typical sign of bleeding. In cases of significant blood loss, compensatory mechanisms usually lead to hypotension rather than hypertension due to reduced circulating volume. A hypertensive response may occur due to pain or stress but does not indicate hemorrhage.

B. 2+ edema: Postoperative edema can occur from fluid shifts, inflammation, or IV fluid administration but is not a direct indicator of active bleeding. Bleeding is more likely to cause signs of hypovolemia, such as tachycardia or hypotension, rather than localized swelling.

C. Tachycardia: A common early sign of bleeding, as the body compensates for decreased blood volume by increasing heart rate to maintain oxygen delivery. Persistent tachycardia in a postoperative client should raise suspicion for internal bleeding, especially if accompanied by hypotension or pallor.

D. Crackles in lungs: Crackles are usually linked to fluid overload, pneumonia, or heart failure rather than bleeding. Pulmonary congestion may develop after aggressive IV fluid resuscitation, but bleeding primarily manifests with hemodynamic instability rather than respiratory symptoms.