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?
Change the PN infusion bag every 48 hr.
Prepare the client for a central venous line.
Obtain random blood glucose daily.
Administer the PN and fat emulsion separately.
The Correct Answer is B
Prepare the client for a central venous line.
Parenteral nutrition (PN) with 20% dextrose and fat emulsions is a hypertonic solution that requires infusion through a central venous line to prevent damage to peripheral veins.
Choice A is wrong because the PN infusion bag should be changed every 24 hours, not every 48 hours.
Choice C is wrong because blood glucose should be monitored more frequently than once daily when initiating PN therapy.
Choice D is wrong because PN and fat emulsions can be administered together in a total nutrient admixture (TNA)1.
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Related Questions
Correct Answer is B
Explanation
Assisting with ambulation for a client who has a pulmonary infection.
Assistive personnel can perform basic nursing care functions such as assisting patients with mobility.
Choice A is wrong because showing a client how to use an incentive spirometer prior to surgery requires more specialized knowledge and training.
Choice C is wrong because irrigating a client’s infected surgical wound is a more complex medical procedure that should be performed by a licensed nurse.
Choice D is wrong because inserting a glycerin suppository for a client who is constipated is also a more complex medical procedure that should be performed by a licensed nurse.
Correct Answer is B
Explanation
A. Change the tubing set every 72 hr:Continuous enteral feeding tubing sets should generally be changed every 24 hours to reduce the risk of bacterial contamination. Changing every 72 hours is too long and increases infection risk.
B. Aspirate residual volume every 4 hr:Aspiration of residual volume every 4 hours is standard practice when providing continuous enteral feedings. This ensures the client is tolerating the feedings and helps prevent aspiration or overfeeding. Large residual volumes may indicate poor gastric emptying.
C. Flush the tubing with 10 mL of water every 2 hr:The tubing should be flushed with 30 mL of water every 4-6 hours (depending on protocol), not just 10 mL, to maintain tube patency and prevent clogging.
D. Heat the formula to 40.5° C (105° F):Formula should not be heated to such a high temperature. It should be administered at room temperature to avoid discomfort and potential damage to the gastrointestinal tract.
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