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 C

Explanation

A. Hypermagnesemia is not typically associated with refeeding syndrome. In fact, hypomagnesemia is more common due to the rapid shift of electrolytes and the body's increased demand during refeeding.
B. Hyponatremia is not a hallmark of refeeding syndrome. This condition more commonly leads to electrolyte imbalances like hypophosphatemia, hypokalemia, and hypomagnesemia rather than low sodium levels.
C. Hypophosphatemia is a hallmark finding in refeeding syndrome. As the body shifts from catabolic to anabolic states during refeeding, phosphorus is rapidly used in cellular processes, and its levels drop, which can lead to muscle weakness, respiratory failure, and other complications.
D. Hyperkalemia is not typically associated with refeeding syndrome. The condition is more likely to cause hypokalemia due to the shift of potassium into cells during the anabolic process after refeeding.

A. An intolerance to the feedings B. Esophageal perforation with fistula formation into the lung C. Extension of the tumor into the aorta D. Leakage of fluids into the mediastinum

Correct Answer is B

Explanation

A. An intolerance to the feedings might cause discomfort, but it would not typically cause increasing pain, fever, and dyspnea. These symptoms are more indicative of a serious complication.
B. Esophageal perforation with fistula formation into the lung is the most likely cause of these symptoms. A perforation can lead to leakage of gastric contents into the pleural space or mediastinum, causing fever, pain, and respiratory distress. The formation of a fistula between the esophagus and the lung would lead to dyspnea.
C. Extension of the tumor into the aorta is a rare complication that would typically manifest with symptoms related to cardiovascular issues, not gastrointestinal symptoms like fever and dyspnea.
D. Leakage of fluids into the mediastinum is a possible cause of the symptoms, but esophageal perforation with a fistula into the lung is more directly linked to these specific symptoms, especially dyspnea.

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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

A nurse is caring for a client who is receiving total parenteral nutrition and develops refeeding syndrome. The nurse should expect which of the following laboratory findings?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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