A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The nurse notices that the solution bag is almost empty and there is not another bag of TPN to administer. Which of the following IV solutions should the nurse administer until the next bag of TPN solution is available?
59% dextrose in lactated Ringer's solution (DLR)
0.45% sodium chloride (0.45% NaCl)
10% dextrose in water (DW)
Lactated Ringer's solution
The Correct Answer is C
Rationale:
A. 59% dextrose in lactated Ringer’s is not a standard solution and would be hypertonic and unsafe.
B. 0.45% sodium chloride does not provide the glucose necessary to prevent hypoglycemia.
C. 10% dextrose in water (D10W) is correct. If TPN runs out, a dextrose-containing solution should be administered to prevent hypoglycemia until the next TPN bag is available.
D. Lactated Ringer’s does not provide sufficient glucose to maintain blood sugar during TPN interruption.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
Rationale:
A. Decompensated cirrhosis impairs the liver’s ability to process bilirubin, leading to yellowing of the skin and eyes.
B. Accumulation of ammonia and other toxins due to liver dysfunction can cause confusion, altered level of consciousness, and asterixis.
C. Fluid shifts into the peritoneal cavity occur due to low albumin levels and portal hypertension, causing abdominal distention.
D. While beneficial for overall health, exercise is not a clinical manifestation of cirrhosis.
Correct Answer is C
Explanation
Rationale:
A. Metabolic acidosis would present with a low pH and low HCO₃⁻. Here HCO₃⁻ is near normal (26 mEq/L), so a primary metabolic disorder is unlikely. The elevated PaCO₂ explains the acidemia.
B. Respiratory alkalosis produces an increased pH and decreased PaCO₂. This ABG shows a low pH and markedly elevated PaCO₂ (68 mm Hg), so it is not respiratory alkalosis.
C. The low pH (7.22) with a markedly elevated PaCO₂ (68 mm Hg) indicates primary respiratory acidosis due to hypoventilation (consistent with RR 7/min). The bicarbonate (26 mEq/L) is near normal, suggesting an acute respiratory acidosis with little metabolic compensation. The low PaO₂ and low saturation indicate significant hypoxemia as well.
D. Metabolic alkalosis would show an elevated pH with an elevated HCO₃⁻. This ABG demonstrates acidemia with normal HCO₃⁻ and high PaCO₂, so metabolic alkalosis is not the cause.
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