A nurse is providing discharge teaching to a client who will receive total parenteral nutrition (TPN) at home. Which of the following information should the nurse include?

Instruct the client that their central line dressing must be changed every 24 hr.

Instruct the client to weigh themselves daily and record their weight.

Instruct the client that one container of TPN may infuse for up to 72 hr.

Instruct the client to speed up the rate of their TPN infusion if it falls behind schedule.

Answer and Explanation

The Correct Answer is B

A) Instruct the ’lient that their central line dressing must be changed every 24 hr: While it's essential to maintain proper hygiene a’d care for a central line to prevent infection, changing the dressing every 24 hours may not be necessary. The frequency of dressing changes depends on institutional policies and the client's condition. Providing accurate informat’on about dressing changes based on specific guidelines is important for the client's safety and the prevention of central l’ne-related infections.

B) Instruct the client to weigh themselves daily and record their weight: This is the correct instruction. Monitoring daily weight allows for the assessment of fluid status and the effectiveness of TPN therapy. Weight gain or loss can indicate fluid retention or depletion, respectively, which may necessitate adjustments to the TPN prescription. Recording daily weights provides valuable data for healthcare providers to evaluate the client's response to TPN and make appropriate m’difications to the treatment plan.

C) Instruct the client that one container of TPN may infuse for up to 72 hr: The duration of TPN administration varies depending on factors such as the client's nutritional needs, medical condition, ’nd the stability of the TPN solution. While some TPN solutions may be stable for up to 24-48 hours, infusing for 72 hours could increase the risk of contamination and compromise the integrity of the solution, leading to adverse effects. Providing accurate information about the duration of TPN infusion based on the specific prescription ensures the client's safety and the efficacy of therapy.

D’ Instruct the client to speed up the rate of their TPN infusion if it falls behind schedule: Altering the rate of TPN infusion without healthcare provider guidance can lead to complications such as hyperglycemia, electrolyte imbalances, or fluid overload. TPN infusion rates are carefully prescribed based on the client's nutritional needs and metabolic status’ If the infusion falls behind schedule, it's essential for the client to contact th’ir healthcare provider for guidance on adjusting the infusion rate or managing any potential issues.

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Correct Answer is C

Explanation

A) Morphine 2 mg IV: Morphine is a potent opioid analgesic commonly used to manage moderate to severe pain. However, in this scenario, the client reports pain as 5 on a scale of 0 to 10, which indicates moderate pain. Morphine 2 mg IV may be excessive for this level of pain and could result in unnecessary sedation, respiratory depression, or other opioid-related adverse effects. Therefore, it is not the most appropriate choice for managing the client's pain.

B) Amitriptyline 25 mg PO: Amitriptyline is a tricyclic antidepressant with analgesic properties, but it is not typically used as a first-line treatment for acute postoperative pain. Additionally, it is administered orally and may not provide rapid pain relief in the immediate postoperative period. Therefore, it is not the most suitable option for managing the client's pain after a total knee replacement surgery.

C) Ketorolac 15 mg IV: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that provides potent analgesic and anti-inflammatory effects. It is commonly used for the management of moderate to severe pain, including postoperative pain. In this scenario, the client reports moderate pain after total knee replacement surgery, making ketorolac an appropriate choice for pain management. Administering ketorolac 15 mg IV can provide effective pain relief without the sedative effects of opioids, making it the most suitable PRN medication for the client's pain level.

D) Acetaminophen 650 mg PO: Acetaminophen is a non-opioid analgesic commonly used for mild to moderate pain relief. While acetaminophen is generally safe and effective, it may not provide sufficient pain relief for a client who reports pain as 5 on a scale of 0 to 10 after total knee replacement surgery. Additionally, oral administration may result in delayed onset of action compared to IV medications. Therefore, acetaminophen 650 mg PO may not be the most optimal choice for managing the client's pain in this situation.

A. Lactated Ringer's B. Dextrose 10% in water C. 0.45% sodi’m chloride D. 0.9% sodium chloride

Correct Answer is B

Explanation

A) Lactated Ringer's: Lactated Ringer's solution is not app’opriate in this si’uation because it does not provide the necessary nutrients found in TPN. It is primarily used for fluid replacement and maintenance and does not contain the essential macronutrients required for TPN.

B) Dextrose 10% in water: This is the correct fluid to administer when the current bag of TPN has finished infusing and the next bag is not yet available. Dextrose 10% in water provides a source of glucose, which can help prevent hypoglycemia in clients dependent on TPN. While it does not provide the full spectrum of nutrients found in TPN, it can temporarily meet the client's caloric needs until the next bag of TP’ becomes available.

C) 0.45% sodium chloride: This solution, also known as half-normal saline, is hypotonic and primarily used for hydration and maintenance fluids. It does not provide adequate nutrition and is not a suitable substitute for TPN.

D) 0.9% sodium chloride: This solution, also known as normal saline, is isotonic and used for fluid resuscitation, maintenance, and replacement. Like 0.45% sodium chloride, it does not contain the necessary nutrients for TPN and is not appropriate as a substitute.

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A nurse is providing discharge teaching to a client who will receive total parenteral nutrition (TPN) at home. Which of the following information should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer pain medication to a postoperative client who had a total knee replacement and reports pain as 5 on a scale of 0 to 10. Which of the following PRN medications should the nurse plan to administer?

Correct Answer is C

Explanation

A nurse is caring for a client whose current bag of total parenteral nutrition (TPN) has finished infusing, and the next bag is not yet available. Which of the following fluids should the nurse prepare to administer?

Correct Answer is B

Explanation

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