A nurse is caring for a client who weighs 190 lb and is receiving total parenteral nutrition. If the RDA of protein is 0.8 g/kg of body weight, how many grams of protein should the client receive daily? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. Increasing the rate of infusion if administration is delayed is not appropriate. TPN should be administered at a specific rate to prevent complications such as hyperglycemia or fluid overload. If the infusion is delayed, the nurse should follow protocols to adjust the timing or inform the healthcare provider, not increase the rate arbitrarily.

B. Monitor serum blood glucose during infusion is appropriate. TPN solutions often contain high concentrations of glucose, which can increase the risk of hyperglycemia. Regular monitoring of blood glucose levels is essential to prevent complications.

C. Infusing 0.9% sodium chloride if the solution is not available is not appropriate. TPN should not be infused with other solutions like normal saline unless specifically instructed by the healthcare provider. If TPN is unavailable, the nurse should contact the provider for guidance or use an alternative solution designed for parenteral nutrition.

D. Verify the solution with another RN prior to infusion is appropriate. Verifying the TPN solution with another RN is a safety measure to ensure the correct solution is administered and to prevent errors in medication delivery.

E. Obtain the client's weight daily is appropriate. Daily weight measurement is important to assess the client’s fluid balance and nutritional status while on TPN.

A. Alopecia (hair loss) is a common manifestation of malnutrition. Protein deficiency, in particular, can lead to thinning hair or hair loss.

B. Diplopia (double vision) is not a typical manifestation of malnutrition. While malnutrition can affect vision in extreme cases, diplopia is more often associated with neurological or other systemic conditions.

C. Oily skin is not typically associated with malnutrition. In fact, malnutrition often leads to dry, flaky skin due to deficiencies in essential fatty acids and other nutrients.

D. Increased salivation is not a typical manifestation of malnutrition. It may occur in some specific conditions, but it is not commonly linked to malnutrition.