A nurse is caring for a client who is receiving parenteral nutrition and identifies that the client has hypoglycemia. Which of the following actions should the nurse take?
Discontinue the infusion.
Obtain arterial blood gasses.
Warm formula to room temperature.
Administer IV dextrose.
The Correct Answer is D
A) Discontinue the infusion: While discontinuing the parenteral nutrition infusion may be necessary in severe cases of hypoglycemia, it should not be the initial action unless the client's condition warrants it. Discontinuing the infusion without providing alternative sources of glucose may exacerbate the hypoglycemia and lead to further complications.
B) Obtain arterial blood gases: Arterial blood gases (ABGs) are not typically indicated for evaluating hypoglycemia. While ABGs provide valuable information about acid-base balance and oxygenation status, they do not directly assess blood glucose levels or contribute to the management of hypoglycemia.
C) Warm formula to room temperature: Warming the parenteral nutrition formula to room temperature may improve comfort during administration, but it is not directly related to managing hypoglycemia. Hypoglycemia requires prompt intervention to raise blood sugar levels, and warming the formula would not address the immediate need for glucose supplementation.
D) Administer IV dextrose: Hypoglycemia is a potentially serious complication of parenteral nutrition administration, especially if the infusion rate is too high or if the client's metabolic needs are not adequately met. IV dextrose, a concentrated glucose solution, is the most appropriate intervention for treating hypoglycemia in this situation. It provides a rapid source of glucose to raise blood sugar levels quickly and effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B) Sepsis: Propofol is an intravenous sedative-hypnotic agent commonly used for sedation in mechanically ventilated patients. While propofol itself does not directly cause sepsis, its use can increase the risk of sepsis-related complications, such as infection. Propofol is typically administered intravenously, and improper handling or contamination of equipment, including intravenous lines and medication vials, can introduce pathogens into the bloodstream, leading to bloodstream infections (sepsis). Additionally, prolonged use of propofol may suppress immune function, further increasing the susceptibility to infection. Therefore, the nurse should monitor the client for signs and symptoms of sepsis, such as fever, chills, hypotension, tachycardia, and altered mental status, as a potential complication of propofol administration.
A) Hypokalemia: Hypokalemia, or low potassium levels, is not a common complication directly associated with propofol administration. While electrolyte imbalances may occur in critically ill patients, especially those receiving mechanical ventilation, hypokalemia is more likely to result from other factors such as diuretic therapy, gastrointestinal losses, or inadequate potassium intake.
C) Urinary retention: Urinary retention is not a typical complication of propofol administration. While sedative medications like propofol can affect bladder function, causing urinary retention in some cases, it is not a commonly reported complication of propofol use in mechanically ventilated patients.
D) Hypoglycemia: Hypoglycemia, or low blood sugar levels, is a potential complication of propofol administration, particularly in critically ill patients who may have altered glucose metabolism. However, hypoglycemia is not as commonly associated with propofol use as sepsis-related complications. Close monitoring of blood glucose levels is essential when administering propofol, especially if the client has preexisting diabetes mellitus or other risk factors for hypoglycemia. However, sepsis is a more direct and significant complication associated with propofol administration in mechanically ventilated patients.
Correct Answer is B
Explanation
A) Lactated Ringer's: Lactated Ringer's solution is not app’opriate in this si’uation because it does not provide the necessary nutrients found in TPN. It is primarily used for fluid replacement and maintenance and does not contain the essential macronutrients required for TPN.
B) Dextrose 10% in water: This is the correct fluid to administer when the current bag of TPN has finished infusing and the next bag is not yet available. Dextrose 10% in water provides a source of glucose, which can help prevent hypoglycemia in clients dependent on TPN. While it does not provide the full spectrum of nutrients found in TPN, it can temporarily meet the client's caloric needs until the next bag of TP’ becomes available.
C) 0.45% sodium chloride: This solution, also known as half-normal saline, is hypotonic and primarily used for hydration and maintenance fluids. It does not provide adequate nutrition and is not a suitable substitute for TPN.
D) 0.9% sodium chloride: This solution, also known as normal saline, is isotonic and used for fluid resuscitation, maintenance, and replacement. Like 0.45% sodium chloride, it does not contain the necessary nutrients for TPN and is not appropriate as a substitute.
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