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.
Prepare the client for a central venous line.
Obtain a random blood glucose daily.
Change the PN infusion bag every 48 hr.
The Correct Answer is B
Choice A rationale:
Administering the PN and fat emulsion separately is not necessary; they can be combined into one solution for administration.
Choice B rationale:
Preparing the client for a central venous line is appropriate when administering parenteral nutrition (PN) with a high dextrose concentration and fat emulsions. A central venous line is typically used for PN with higher osmolarity.
Choice C rationale:
Obtaining a random blood glucose daily is important for monitoring the client's response to PN but does not address the initial plan of care.
Choice D rationale:
Changing the PN infusion bag every 48 hours is not a standard practice. The frequency of bag changes should follow the facility's policy and the product manufacturer's guidelines.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Providing brochures about the procedure may be helpful, but the immediate concern is the client's expressed lack of understanding.
Choice B rationale:
Notifying the provider is the first action to address the client's concerns and ensure that the client has a clear understanding of the surgery. The nurse should also document the client's statement and the provider's response in the medical record.
Choice C rationale:
Describing the surgery to the client is important, but the provider should be informed first to address the client's immediate concerns.
Choice D rationale:
Completing an incident report is not applicable in this context, as it involves a communication issue rather than an incident.
Correct Answer is C
Explanation
Choice A rationale:
Verifying the count total after removing the required amount is a step in ensuring accurate medication administration, but it is not specifically related to controlled substances.
Choice B rationale:
Asking a second nurse to record her signature is a recommended practice when wasting any unused portion of a controlled substance to ensure accountability.
Choice C rationale:
Reporting any discrepancy in the count total is essential, especially for controlled substances, to maintain accuracy and detect potential diversion.
Choice D rationale:
Placing the wasted portion in the sharps container is not the correct disposal method for controlled substances. Controlled substances should be witnessed and documented during disposal.
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