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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C"]
Explanation
Leaving the drain until the end of the shift is not appropriate because it could lead to complications such as:
- Hematoma formation:Blood accumulation in the tissues surrounding the drain can put pressure on surrounding structures,potentially impairing blood flow and causing tissue damage.
- Infection:A reservoir containing blood provides a favorable environment for bacterial growth,increasing the risk of infection.
- Drain occlusion:Clotted blood can block the drain,preventing effective drainage and leading to fluid buildup and potential infection.
- Decreased wound healing:Excessive blood loss can delay wound healing by depriving the tissues of necessary oxygen and nutrients.
Removing the drain without the surgeon's order is not appropriate because:
- Premature removal:It could disrupt the healing process and lead to complications such as fluid collection or infection.
- Assessment limitation:Removing the drain would eliminate the ability to monitor ongoing blood loss and could mask potential complications.
A Jackson-Pratt drain works by creating suction when the bulb is squeezed and emptied¹. The bulb should be emptied before it is more than half full to avoid the discomfort of the weight of the drain pulling on the internal tubing and to maintain the suction
Notifying the surgeon about the blood loss is wrong because it is not an urgent situation unless there are signs of excessive bleeding, such as bright red blood, clots, or a sudden increase in the amount of drainage²³. The surgeon should be notified if the drainage is more than 100 ml in 24 hours or if the color changes from serosanguineous (pink) to sanguineous (red)
Correct Answer is D
Explanation
This statement indicates that the client understands the importance of gradually adjusting to wearing a hearing aid.
It can take time for the brain to adapt to new sounds and volume levels, so it’s important to increase usage gradually.
Choice A is wrong because turning the hearing aid up as high as it will go can cause discomfort and may not improve hearing.
Choice B is wrong because hearing aids typically last several years with proper care and maintenance.
Choice C is wrong because it’s important to remove the battery from the hearing aid when not in use to preserve battery life.
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