A nurse is caring for a client who has Crohn's disease and is receiving parenteral nutrition. Which of the following interventions should the nurse include in the care of this client?

Remove unused parenteral nutrition after 12 hr of use.

Monitor the flow rate of the parenteral nutrition carefully and increase the rate as needed if it falls behind.

Remove the parenteral nutrition solution from the refrigerator 2 hr before infusion.

Monitor daily laboratory values and report as needed.

Answer and Explanation

The Correct Answer is D

A. Parenteral nutrition (PN) should not be left out for extended periods. Generally, unused PN should be discarded after 24 hours, not 12 hours, to prevent contamination and bacterial growth.
B. The flow rate of PN should be monitored and adjusted carefully, but it should not be increased without orders. Rapid adjustments could cause complications such as fluid overload or electrolyte imbalances.
C. PN solution should be removed from the refrigerator 1 to 2 hours before use to allow it to come to room temperature, but 2 hours may be too long. It should be done cautiously to avoid bacterial growth at room temperature.
D. Monitoring daily laboratory values is essential for assessing the client's nutritional status, electrolytes, liver function, and kidney function. These values help guide ongoing care and detect complications of PN, such as electrolyte imbalances or liver dysfunction.

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Correct Answer is A

Explanation

A. A hiatal hernia can increase the risk of gastroesophageal reflux disease (GERD) because the hernia can cause the lower esophageal sphincter to malfunction, leading to the backflow of stomach acid into the esophagus. This increases the risk of reflux symptoms, such as heartburn and regurgitation.
B. There is no direct link between a hiatal hernia and an increased risk for stomach cancer. While long-term GERD can contribute to other esophageal issues, such as Barrett’s esophagus, it does not directly cause stomach cancer.
C. A hiatal hernia does not increase the risk of intestinal cancer. Its primary association is with GERD and related complications.
D. A hiatal hernia is not associated with an increased risk for lung disease. However, severe GERD symptoms can cause respiratory issues such as aspiration pneumonia, but this is not the same as directly increasing the risk of lung disease.

A. Change the IV tubing every 24 hr. B. Change the IV site dressing every 4 days. C. Weigh the client every other day. D. Obtain the client's blood glucose every 12 hr.

Correct Answer is A

Explanation

A. The IV tubing for TPN should be changed every 24 hours to prevent infection, as TPN is a high-risk solution for bacterial growth due to its high glucose content. Regular changes help reduce the risk of contamination and complications such as bloodstream infections.
B. The IV site dressing should be changed at least every 48 to 72 hours (or per institutional policy) to maintain aseptic technique and minimize infection risk. Changing the dressing every 4 days may exceed this timeframe and increase the risk of infection.
C. Weighing the client is important to monitor fluid balance, but daily weighing is more typical than every other day for clients receiving TPN. This helps to assess nutritional status and detect potential fluid overload or deficit.
D. Blood glucose levels should be monitored more frequently, typically every 6 hours, because TPN can cause significant fluctuations in blood glucose. Checking every 12 hours would not be adequate for early detection of hyperglycemia or hypoglycemia.

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A nurse is caring for a client who has Crohn's disease and is receiving parenteral nutrition. Which of the following interventions should the nurse include in the care of this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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