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.
Administer the PN and fat emulsion separately.
Prepare the client for a central venous line.
Obtain a random blood glucose daily.
The Correct Answer is C
Rationale: Parenteral nutrition (PN) is a method of providing essential nutrients to the body through a central vein. PN is indicated for clients who cannot take oral or enteral nutrition due to intestinal failure or other conditions. PN requires a central venous line because the solution is hypertonic and can cause thrombophlebitis or damage to peripheral veins. A central venous line also allows for better monitoring of fluid balance and electrolyte levels.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["475 "]
Explanation
To calculate the client's intake for that 4-hr period in ml, we need to convert the liquid amounts from oz to ml using the following formula:
1 ml = oz * 29.5735296
Using this formula, we can convert the milk, orange juice, tea, and water amounts to ml: Milk: 3 oz * 29.5735296 ml/oz = 88.7205888 ml
Orange juice: 2 oz * 29.5735296 ml/oz = 59.1470592 ml
Tea: 3 oz * 29.5735296 ml/oz = 88.7205888 ml
Water: 4 oz * 29.5735296 ml/oz = 118.2941184 ml
The total intake from these liquids is:
88.7205888 + 59.1470592 + 88.7205888 + 118.2941184 = 354.8823552 ml We also need to add the intake from the IV infusion, which is given at a rate of 30 mL/hr for 4 hours:
30 mL/hr * 4 hr = 120 mL
The total intake from the IV infusion is:
120 mL
The total intake for that 4-hr period in ml is:
354.8823552 + 120 = 474.8823552 ml
Rounding the answer to the nearest whole number, we get:
475 ml
Correct Answer is A
Explanation
A. Before administering enteral feeding, it is important to check the gastric residual volume to ensure that the previous feeding has been adequately digested and to reduce the risk of aspiration. High residual volumes can indicate delayed gastric emptying and may require holding the feeding.
B. While it is important to flush the tube, this is typically done with water (sterile or tap) rather than sterile 0.9% sodium chloride, unless specifically ordered for medical reasons. The primary step before feeding is to check the residual volume.
C. Encouraging the client to take sips of water is not applicable in the context of enteral feeding via NG tube, as the feeding is delivered directly into the stomach or intestines.
D. Encouraging deep breathing and coughing is not relevant to the administration of enteral feedings via an NG tube. These actions are more related to respiratory care.
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