A nurse is planning care for a client who has a new prescription for total parenteral nutrition (TPN). Which of the following actions should the nurse plan to take?
Change the IV tubing for TPN solution every 72 hr.
Remove TPN from the refrigerator 5 min before infusing it.
Discard remaining TPN solution that is still infusing after 24 hr.
Change the dressing around the IV site weekly.
The Correct Answer is C
The nurse should plan to change the IV tubing for the TPN solution every 72 hours. This is necessary to maintain the sterility of the system and minimize the risk of infection. TPN solutions are prone to bacterial growth, and changing the tubing regularly helps prevent contamination.
Removing TPN from the refrigerator 5 minutes before infusing it is not necessary. TPN solutions are typically stored in the refrigerator to maintain their stability and prevent spoilage. It should be brought to room temperature over a longer period of time, usually 30-60 minutes, before administration.
Discarding the remaining TPN solution that is still infusing after 24 hours is unnecessary. TPN solutions can typically be infused for up to 24 hours without compromising their safety and efficacy. However, it is important to monitor the solution closely for any signs of contamination or degradation, and if any concerns arise, the nurse should consult with the healthcare provider.
Changing the dressing around the IV site weekly is not specific to TPN administration. Dressing changes for peripheral IV sites are typically performed according to facility protocols and the condition of the site, but they are not necessarily done on a weekly basis. The frequency of dressing changes depends on factors such as the type of dressing used, the patient's condition, and any signs of infection or dislodgement.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Check for gastric residual: Gastric residual refers to the volume of formula or contents in the stomach before the next feeding. Checking for gastric residual helps determine if the client is tolerating the feeding properly. If the gastric residual is high, it may indicate delayed gastric emptying or intolerance to the feeding, which can lead to cramping and abdominal distention. The nurse can assess the gastric residual volume and consult with the healthcare provider to determine the appropriate course of action.
Apply low intermittent suction: Applying low intermittent suction is not typically indicated for a client receiving a continuous enteral tube feeding. Suction is more commonly used for clients who have an aspiration risk or need intermittent gastric decompression. In the given scenario, the client is experiencing cramping and abdominal distention, which may require a different approach.
Request a higher-fat formula: Requesting a higher-fat formula may not be the appropriate action at this time. High-fat formulas can contribute to gastrointestinal issues such as increased risk of diarrhea or malabsorption. It is important to assess the client's tolerance to the current formula before considering changes.
Increase the rate of the feeding: Increasing the rate of the feeding may worsen the client's symptoms. Rapid administration of enteral feedings can overwhelm the gastrointestinal system and lead to complications such as cramping, distention, and diarrhea. It is generally recommended to start at a low rate and gradually increase it based on the client's tolerance.
Correct Answer is C
Explanation
"Position the newborn at a 20-degree angle after feeding": This is the correct instruction. After feeding, it is beneficial to position the newborn at a slight angle, usually around 20 degrees, to help reduce gastroesophageal reflux. This position helps gravity keep the stomach contents down and prevents them from regurgitating back into the esophagus.
"Provide a small feeding just before bedtime": This instruction is not recommended for a newborn with gastroesophageal reflux. It is advisable to avoid feeding the baby just before bedtime as lying down can worsen the reflux symptoms. Instead, it is generally recommended to keep the baby upright for some time after feeding to allow for proper digestion and minimize reflux.
"Place the newborn in a side-lying position if vomiting": Placing the newborn in a side-lying position after vomiting is not recommended. This position does not provide adequate support to prevent choking or aspiration in case of vomiting. Instead, it is recommended to keep the newborn in an upright or slightly elevated position after feeding to minimize reflux.
"Dilute formula with 1 tablespoon of water": Diluting formula with water is not a recommended practice unless specifically advised by a healthcare provider. It is important to follow the instructions on the formula packaging or the healthcare provider's guidance regarding formula preparation to ensure appropriate nutrition and hydration for the newborn.
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