A nurse is planning care for a client who has a new prescription to receive a continuous infusion of total parenteral nutrition (TPN) Which of the following interventions should the nurse implement?
Change the TPN infusion tubing once every 3 days
Check the client's blood glucose level regularly
Insert the peripheral IV catheter for administration
Monitor the client's weight every 3 days
The Correct Answer is B
When caring for a client receiving a continuous infusion of total parenteral nutrition (TPN), the nurse should implement the intervention of checking the client's blood glucose level regularly. TPN is a highly concentrated intravenous nutrition solution containing glucose, amino acids, lipids, vitamins, and minerals, and it is used to provide complete nutrition when the client cannot take oral nutrition.
Monitoring blood glucose levels regularly is essential because TPN is rich in glucose, which can significantly affect the client's blood sugar levels. Hyperglycemia (high blood sugar) is a potential complication of TPN infusion. Regular blood glucose monitoring allows the nurse to detect and address any changes in blood sugar levels promptly and to adjust the TPN infusion rate or administer insulin, if necessary, to maintain the client's blood sugar within the target range.
Let's go through the other options:
A. Change the TPN infusion tubing once every 3 days: While changing the TPN infusion tubing regularly is a good practice to maintain asepsis and prevent infection, it is not the priority intervention in this situation. Regularly checking the client's blood glucose level is more crucial to monitor the effects of TPN on blood sugar levels.
C. Insert the peripheral IV catheter for administration: Total parenteral nutrition is a hypertonic solution that can cause irritation and damage to peripheral veins. It is usually administered through a central venous catheter (CVC) placed in a large vein, such as the subclavian or jugular vein. Inserting a peripheral IV catheter for TPN administration is not recommended due to the risk of vein damage and thrombosis.
D. Monitor the client's weight every 3 days: Monitoring the client's weight is an important part of assessing their nutritional status and fluid balance. However, the priority intervention for a client receiving TPN is checking their blood glucose level regularly, as hyperglycemia is a common and significant concern in TPN administration.
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Related Questions
Correct Answer is ["200"]
Explanation
To determine the infusion rate in mL/h, we need to divide the total volume (100 mL) by the total time (30 minutes) and then convert the result to hours.
100 mL / 30 min = 3.33 mL/min
To convert minutes to hours, we multiply by 60:
3.33 mL/min * 60 min/h = 199.8 mL/h
Rounding to the nearest whole number, the nurse should set the IV infusion pump to deliver 200 mL/h.
Correct Answer is ["0.12"]
Explanation
To calculate the rate at which the IV pump should be set to deliver dopamine, we need to determine the total amount of dopamine in the infusion and divide it by the desired dose per minute.
Given:
Dopamine concentration: 400 mg in 250 mL
Desired dose: 5 mcg/kg/min
Patient weight: 220 lb
First, we need to convert the patient's weight from pounds to kilograms:
220 lb ÷ 2.2 = 100 kg
Next, we need to calculate the total amount of dopamine needed per minute:
5 mcg/kg/min × 100 kg = 500 mcg/min
Now, we need to convert the dopamine dose from mcg to mg:
500 mcg/min ÷ 1000 = 0.5 mg/min
To determine the infusion rate in mL/hr, we divide the dose in mg/min by the dopamine concentration in the infusion solution:
0.5 mg/min ÷ 250 mL = 0.002 mL/min
Finally, we convert the infusion rate from mL/min to mL/hr by multiplying by 60:
0.002 mL/min × 60 min = 0.12 mL/hr
Therefore, the nurse should set the IV pump to deliver 0.12 mL/hr.
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