A nurse is observing a newly licensed nurse who is administering total parenteral nutrition (TPN) to a client. Which of the following actions by the newly licensed nurse indicates a need for the nurse to intervene?
Plans for a check of the client's fingerstick glucose level every 6 hr
Schedules a bag and tubing change for 24 hr after the start of the infusion
Uses the TPN IV tubing to administer the client's next dose of antibiotics
Gradually increases the TPN infusion rate each hour until the prescribed rate is achieved
The Correct Answer is C
A. Plans for a check of the client's fingerstick glucose level every 6 hr: Monitoring blood glucose levels is essential for clients receiving TPN due to the risk of hyperglycemia. Checking glucose every 6 hours is a standard practice that helps ensure appropriate glycemic control, so this action is appropriate.
B. Schedules a bag and tubing change for 24 hr after the start of the infusion: It is standard practice to change the TPN bag and tubing every 24 hours to reduce the risk of infection and maintain sterility. This timing aligns with best practices for TPN administration, indicating no need for intervention.
C. Uses the TPN IV tubing to administer the client's next dose of antibiotics: Using the TPN line for additional medications, such as antibiotics, can lead to complications like incompatible drug interactions or infection. TPN should ideally be delivered through a dedicated line to prevent these risks, which necessitates intervention from the supervising nurse.
D. Gradually increases the TPN infusion rate each hour until the prescribed rate is achieved: Gradual escalation of the TPN infusion rate is important to prevent complications such as hyperglycemia. This action is appropriate, as it allows the body to adapt to the increased caloric intake safely.
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Related Questions
Correct Answer is A
Explanation
A) Perform the procedure prior to meals: This is the correct action. Postural drainage should ideally be performed before meals to minimize the risk of vomiting and to ensure the child is comfortable during and after the procedure.
B) Perform the procedure twice each day: While frequency may vary based on the child's needs, it is often recommended to perform postural drainage more frequently than twice a day, depending on the severity of the condition and the child's specific respiratory needs.
C) Administer a bronchodilator after the procedure: Bronchodilators are typically administered before postural drainage to help open the airways and improve the effectiveness of the drainage. Giving them after the procedure is not standard practice.
D) Hold hand flat to perform percussions on the child: The correct technique for performing chest percussion is to cup the hand slightly, creating a pocket of air that helps to effectively dislodge mucus. A flat hand can be less effective and may not provide the necessary impact.
Correct Answer is C
Explanation
A) Taking your temperature 1 hour after getting out of bed is not appropriate for the basal body temperature method. For accurate tracking, temperature should be taken immediately upon waking, before any activity or movement that could affect the reading.
B) Taking your temperature every night before going to bed does not align with the basal body temperature method. This method requires consistent morning measurements to track ovulation accurately, as body temperature can fluctuate throughout the day.
C) Taking your temperature immediately after waking and before getting out of bed is the correct instruction. This ensures the reading reflects the body's resting temperature, which can help identify the slight increase that occurs after ovulation, aiding in family planning efforts.
D) Taking your temperature within 30 minutes after your first morning void is not suitable for this method. The ideal time is right upon waking, and any activity, including using the bathroom, can alter body temperature and lead to inaccurate readings.
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