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.
Discard the remaining TPN solution that is still infusing after 24 hr.
Change the dressing around the IV site weekly.
Remove TPN from the refrigerator 5 min before infusing it.
The Correct Answer is B
Choice A rationale:
Changing the IV tubing for TPN solution every 72 hr is not necessary unless there is a complication or a specific reason to do so. TPN tubing should be changed based on the facility's protocol and the patient's condition, not on a fixed time frame.
Choice B rationale:
This choice is the correct answer. TPN solutions are susceptible to bacterial growth due to their nutrient-rich composition. Discarding any remaining TPN solution after 24 hr helps minimize the risk of bacterial contamination and subsequent infection in the patient.
Choice C rationale:
Changing the dressing around the IV site weekly is a common practice for peripheral IV sites, but TPN administration usually requires a more frequent dressing change due to the higher risk of infection associated with central venous access.
Choice D rationale:
Removing TPN from the refrigerator 5 min before infusing it is unnecessary. TPN solutions are typically stored in a refrigerator and should be brought to room temperature gradually before administration. However, 5 minutes is not sufficient time for the solution to reach an appropriate temperature.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Serum potassium at 4.8 mEq/L is within the normal range (typically around 3.5-5.0 mEq/L), but potassium levels are not the primary concern when assessing the effectiveness of a phosphate binder for end-stage renal disease.
Choice B rationale:
This choice is the correct answer. Total calcium levels around 9.7 mg/dL (normal range approximately 8.5-10.2 mg/dL) are important indicators of the effectiveness of a phosphate binder. These levels reflect the balance between calcium and phosphate in the body, which is crucial for bone health and various physiological functions.
Choice C rationale:
Sodium at 136 mEq/L (normal range approximately 135-145 mEq/L) is within the normal range but is not a direct indicator of the effectiveness of a phosphate binder for end-stage renal disease.
Choice D rationale:
Hemoglobin at 15 g/dL (normal range varies by gender and age but is roughly 12-16 g/dL for adult females and 14-18 g/dL for adult males) is not related to the effectiveness of a phosphate binder. Hemoglobin levels reflect the oxygen-carrying capacity of the blood and are more relevant in assessing anemia or other blood-related conditions.
Correct Answer is C
Explanation
Choice Arationale:
Applying low intermittent suction is used for nasogastric tube management to remove excess air or gastric contents and is not directly related to addressing cramping and abdominal distention. This action doesn't address the underlying issue.
Choice Brationale:
Increasing the rate of feeding is not the appropriate action to take in response to cramping and abdominal distention. It might worsen the discomfort and potentially overload the client's gastrointestinal system, leading to more issues.
Choice C rationale:
(Correct Choice) Checking for gastric residual is the appropriate action in this scenario. Cramping and abdominal distention can indicate delayed gastric emptying, which might be caused by an accumulation of feeding within the stomach. By checking for gastric residual, the nurse can assess whether there is a significant amount of residual feeding present, which might require adjusting the feeding rate or intervention.
Choice D rationale:
Requesting a higher-fat formula is not the initial action to take when the client reports cramping and abdominal distention. It assumes that the discomfort is due to the formula's composition, which might not be the case. First, assessing for gastric residual and considering other factors is important before changing the formula.
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