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?

Obtain a random blood glucose daily.

Change the PN infusion bag every 48 hr.

Prepare the client for a central venous line.

Administer the PN and fat emulsion separately.

Answer and Explanation

The Correct Answer is C

A.   Obtaining a random blood glucose daily is important for monitoring glucose levels but might not be specifically related to the introduction of PN in this context.
B.   Changing the PN infusion bag every 48 hours might not be universally applicable; the frequency of changing PN bags depends on institutional policies and the stability of the solution being administered.
C.   PN with high concentrations of dextrose and fat emulsions typically requires a central venous line for administration to prevent peripheral vein irritation or damage.
D.   Administering PN and fat emulsion separately might not be practical as PN usually includes all necessary components in a single infusion.

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Correct Answer is A

Explanation

A. In emergency situations where the client is unconscious and requires immediate life-saving surgery, implied consent is assumed. The nurse should prepare the client for surgery without waiting for family members or a formal consent process. Delaying treatment could jeopardize the client's life.

B. Contacting the ethics committee could delay the urgent care needed in an emergency situation. Immediate action should be taken in the best interest of the client.

C. Waiting for a family member to arrive could delay critical care, which may lead to worsening of the client's condition or even death.

D. The surgeon does not need to provide consent. It is the healthcare team's responsibility to act in the client's best interest when the client is unable to provide consent in an emergency.

A. Prime the client's primary IV tubing with lactated Ringer's. B. Confirm the identity of the client with the blood bank technician. C. Check that the client has a small gauge IV catheter in place. D. Check the blood product's compatibility with the client's blood type.

Correct Answer is D

Explanation

A. Priming the IV tubing with lactated Ringer's isn't necessary for administering packed RBCs.
B. Confirming the client's identity with the blood bank technician is crucial but typically done before receiving the blood product.
C. Ensuring the client has a suitable IV catheter is important but isn't the priority before starting the infusion of packed RBCs.
D. Checking the blood product's compatibility with the client's blood type is critical to prevent adverse reactions before starting the infusion.

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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

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