A nurse is planning care for a client who is to start receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?
Change the TPN tubing every 48 hr
Allow 18 hr for the lipids to infuse when not mixed with the TPN solution.
Use a 1.2 micron filter when infusing TPN with fat emulsions added.
Change the TPN solution after 36 hr.
The Correct Answer is C
Rationale:
A. The tubing for TPN must be changed every 24 hr (not 48 hr) to reduce the risk of central line–associated bloodstream infection (CLABSI).
B. Lipid emulsions should not hang for more than 12 hr to prevent bacterial growth and infection.
C. A 1.2-micron filter is required for TPN that contains lipids to remove particulate matter, bacteria, and fungi, since lipid solutions cannot pass through smaller filters.
D. TPN solutions should be changed every 24 hr (not 36 hr) to reduce infection risk.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Magnesium levels may actually drop, not rise, during refeeding syndrome due to intracellular shifts.
B. Calcium levels are typically not elevated as a direct result of refeeding syndrome.
C. Refeeding syndrome occurs when malnourished patients receive rapid carbohydrate reintroduction, triggering insulin release. This drives phosphate, potassium, and magnesium into cells, with phosphate depletion being the hallmark and most clinically significant electrolyte disturbance. Hypophosphatemia can cause muscle weakness, respiratory failure, and cardiac dysfunction.
D. Sodium levels may fluctuate, but hyponatremia is not the primary concern in refeeding syndrome.
Correct Answer is C
Explanation
Rationale:
A. Seizures are more commonly associated with severe electrolyte imbalances like hyponatremia, not mild hypokalemia.
B. Neurogenic shock is related to spinal cord injury, not potassium imbalance.
C. Hypokalemia (potassium 3.3 mEq/L; normal 3.5–5.0 mEq/L) increases the risk of ventricular arrhythmias, palpitations, and potentially life-threatening cardiac complications, especially in clients taking diuretics like furosemide.
D. Low potassium does not directly cause hypoglycemia.
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