A nurse is planning care for a client who has a new prescription for parenteral nutrition (PN) in 20% dextrose and fat emulsions. Which of the following is an appropriate action to include in the plan of care?

Administer the PN and fat emulsion separately.

Change the PN infusion bag every 48 hr.

Obtain a random blood glucose daily.

Prepare the client for a central venous line

Answer and Explanation

The Correct Answer is D

. PN with 20% dextrose requires a central venous line for administration. Peripheral veins cannot handle the high osmolarity of such solutions, which can cause phlebitis and vein damage. A central venous line is necessary to deliver the solution safely into a larger vein with a higher blood flow.
A. Fat emulsions (lipids) are often administered separately from the PN solution, but they can also be infused concurrently through a Y-connector to minimize the risk of contamination. However, it is crucial to follow the specific guidelines of the healthcare facility and the manufacturer’s recommendations. The decision to administer separately or concurrently depends on the prescribed protocol.
B. PN solutions are typically changed every 24 hours to reduce the risk of infection. The high glucose content in PN solutions provides a rich medium for bacterial growth, making it essential to adhere to strict aseptic techniques and timely changes of the infusion bag.
C. Blood glucose monitoring is crucial for clients receiving PN due to the high dextrose content, which can significantly impact blood glucose levels. However, more frequent monitoring, such as every 4-6 hours initially, is often required rather than just a random daily check. This helps in promptly identifying and managing hyperglycemia or hypoglycemia.

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Correct Answer is D

Explanation

D. Rolling the client as one unit in a smooth, continuous motion helps maintain proper alignment of the spine and minimizes the risk of exacerbating the injury. It also reduces the strain on the client's lower back and decreases the likelihood of causing discomfort or injury during the repositioning process.
A. This action is generally appropriate for repositioning a client with a lower back injury. Placing the client's arms at their sides helps maintain proper alignment of the spine and reduces the risk of injury or strain during the repositioning process. However, log rolling is recommended
B. Positioning the client on the side of the bed nearest the direction they will be turned increases the distance and effort required to perform the repositioning maneuver, increasing the risk of injury to both the client and the healthcare provider.
C. Flexing the client's knees can increase tension in the lower back and increase tension during repositioning.

A nurse is caring for a client

Exhibits

A. History of hypertension B. History of rheumatoid arthritis C. Cholesterol level D. History of hyperlipidemia E. Fasting glucose level F. Family history Correct

Correct Answer is ["A","C","D","F"]

Explanation

C. Elevated cholesterol levels, as indicated by a total cholesterol level of 250 mg/dL, are a risk factor for heart disease. High cholesterol levels contribute to the buildup of plaque in the arteries (atherosclerosis), leading to narrowed or blocked arteries and an increased risk of heart attack and stroke.
D. Hyperlipidemia refers to elevated levels of lipids (fats) in the blood, including cholesterol and triglycerides. It is a significant risk factor for heart disease, as high levels of lipids contribute to the development of atherosclerosis and increase the risk of cardiovascular events.
F. A family history of heart disease, especially in first-degree relatives (parents or siblings), increases an individual's risk of developing heart disease. Genetic factors can influence the risk of heart disease, including conditions such as coronary artery disease and familial hypercholesterolemia.
B. Rheumatoid arthritis (RA) is an autoimmune disease that primarily affects the joints. While RA itself is not a direct risk factor for heart disease, chronic inflammation associated with RA can increase the risk of cardiovascular events.
E. While elevated fasting glucose levels can indicate impaired glucose metabolism or prediabetes, they are more directly associated with an increased risk of type 2 diabetes rather than heart disease.
However, individuals with diabetes are at higher risk for heart disease due to various factors, including obesity, high blood pressure, and dyslipidemia.

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A nurse is planning care for a client who has a new prescription for parenteral nutrition (PN) in 20% dextrose and fat emulsions. Which of the following is an appropriate action to include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to reposition a client who has a lower back injury. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is caring for a client Exhibits

Correct Answer is ["A","C","D","F"]

Explanation

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