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.
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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Related Questions
Correct Answer is B
Explanation
A. Fecal output from a new colostomy typically begins within 2 to 4 days, not within 24 hours. This is due to the time needed for bowel function to resume after surgery.
B. A small amount of bleeding around the stoma can occur as part of normal healing, especially in the first few days after surgery. It should not be excessive or prolonged.
C. Raw vegetables and high-fiber foods should be avoided immediately after surgery as they can irritate the digestive tract and cause blockages in the stoma. A low-fiber diet is recommended initially.
D. The stoma should initially be red or pink in color, not purplish. A purplish color could indicate impaired circulation, which would require medical attention.
Correct Answer is C
Explanation
A. Green tea, while it contains some caffeine, is generally not considered a significant risk factor for the development of peptic ulcers. It may have protective effects due to its antioxidant properties, unlike substances that directly irritate the stomach lining.
B. Moderate alcohol consumption, such as a glass of wine, may irritate the stomach lining but is not a primary risk factor for peptic ulcers unless excessive drinking occurs. This would not be the most significant factor for ulcer development.
C. NSAID use is a well-established risk factor for peptic ulcers. NSAIDs inhibit the production of prostaglandins, which protect the stomach lining from acid damage. Chronic use of NSAIDs can lead to ulcer formation due to this inhibition.
D. Bulimia can lead to acid reflux or esophageal irritation, but it is not a direct risk factor for the formation of peptic ulcers. The primary risk factors for peptic ulcers include H. pylori infection and the use of NSAIDs.
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