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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice Arationale:
Albumin in the urine is not an indication of normal kidney function. The presence of albumin in the urine, known as albuminuria, is a sign of kidney damage, especially in individuals with diabetes. It's essential for individuals with diabetes to monitor and manage their kidney health, as kidney damage is a common complication.

Choice Brationale:
Blood glucose levels between 200 and 212 milligrams per deciliter are higher than the recommended target range for individuals with type 1 diabetes. Maintaining blood glucose levels within a healthy range (typically 80-130 mg/dL fasting) is important to prevent complications.

Choice C rationale:
An HbA1c level of five percent is unrealistically low and not achievable. The HbA1c level reflects the average blood glucose level over the past two to three months. While lower HbA1c levels are associated with better diabetes control, aiming for an HbA1c of five percent would pose a risk of hypoglycemia and potential complications.
Choice D rationale:
The statement "I will have ketones in my urine if my blood glucose is maintained at 190 milligrams per deciliter" demonstrates an understanding of the relationship between high blood glucose levels and ketone production. Elevated blood glucose levels can lead to the breakdown of fats for energy, resulting in the production of ketones, which can be detected in the urine. Ketones in the urine can be a sign of inadequate diabetes management and a risk of diabetic ketoacidosis (DKA).

A. "Provide sugar-free candy for the client between meals." B. "Recommend that the client eliminate the intake of carbonated beverages." C. "Instruct the client to increase consumption of beans." D. "Encourage the client to drink 4 oz of milk after each loose stool."

Correct Answer is B

Explanation

Choice A rationale:
Providing sugar-free candy is not an appropriate action for managing chronic diarrhea. Sugar-free candy may contain artificial sweeteners, which could worsen diarrhea or have other gastrointestinal effects. Additionally, candy doesn't address the underlying cause of chronic diarrhea.
Choice B rationale:
Recommending that the client eliminate the intake of carbonated beverages is the correct choice. Carbonated beverages, especially those with added sugars or artificial sweeteners, can contribute to gastrointestinal irritation and exacerbate diarrhea. Avoiding these drinks can help reduce symptoms and promote better digestion.
Choice C rationale:
Instructing the client to increase the consumption of beans is not advisable. Beans are known to cause gas and bloating in some individuals, which could further worsen the client's symptoms of chronic diarrhea. Increasing bean consumption might aggravate gastrointestinal distress.
Choice D rationale:
Encouraging the client to drink 4 oz of milk after each loose stool is not a suitable approach. Milk, particularly in larger quantities, can have a laxative effect in some individuals, potentially worsening the diarrhea. This suggestion could lead to increased discomfort for the client.

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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?

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