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 B

Explanation

A) PTT (Partial Thromboplastin Time): While the PTT is a laboratory test used to assess the intrinsic pathway of the coagulation cascade and monitor the effectiveness of heparin therapy, it is not routinely used to monitor warfarin therapy. Therefore, reviewing the PTT prior to administering warfarin is not necessary.

B) PT (Prothrombin Time): Prothrombin time measures the extrinsic pathway of the coagulation cascade and is commonly used to monitor warfarin therapy. Since warfarin works by inhibiting vitamin K-dependent clotting factors, such as factors II, VII, IX, and X, monitoring the PT allows for the assessment of the anticoagulant effect of warfarin and helps guide dosing adjustments. Therefore, reviewing the PT prior to administering warfarin is essential to ensure appropriate anticoagulation therapy.

C) WBC (White Blood Cell Count): The white blood cell count is not directly related to warfarin therapy monitoring. While an elevated white blood cell count may indicate infection, it is not specific to warfarin therapy and does not influence the administration of the medication.

D) Total iron-binding capacity: Total iron-binding capacity is a laboratory test used to assess iron status and is not relevant to monitoring warfarin therapy. It measures the body's ability to bind and transport iron in the blood, and its results are not indicative of warfarin's anticoagulant effect or dosage adjustments.

A. Monitor the client for seizure activity. B. Check the client's urinary output. C. Monitor the client'’ oxygen saturation. D. Auscultate the c’ient's bowel sounds.

Correct Answer is C

Explanation

A) Monitor the client for seizure activity: While diazepam is an anticonvulsant medication and may be used to prevent or treat seizures, it is unlikely to cause seizure activity as an adverse reaction when administered for moderate sedation. However, if the client has a history of seizures or is at risk for seizures, monitoring for seizure activity is essential. In the context of moderate sedation, the primary concern is related to the sedative effects of diazepam rather than seizure activity.

B) Check the client's urinary output: Monitoring urinary out’ut is important for assessing renal function and fluid balance, but it is not directly related to assessing adverse reactions to diazepam. Adverse reactions to diazepam typically involve central nervous system depression, respiratory depression, or cardiovascular effects. Monitoring urinary output may be part of routine nursing care but is not specific to assessing adverse reactions to diazepam.

C) Monitor the client's oxygen saturation: This is the correct’action. Monitoring the client's oxygen saturation is essential for det’cting adverse reactions to diazepam, such as respiratory depression or hypoventilation. Diazepam can cause respiratory depression, especially when administered in higher doses or in combination with other sedative medications. Monitoring oxygen saturation allows the nurse to detect any signs of hypoxemia early and intervene promptly to ensure adequate oxygenation.

D) Auscultate the client's bowel sounds: While assessing bowel so’nds is important for evaluating gastrointestinal function, it is not directly related to assessing adverse reactions to diazepam. Adverse reactions to diazepam typically involve effects on the central nervous system and respiratory system rather than gastrointestinal function. Monitoring bowel sounds may be part of routine nursing assessment but is not specific to assessing adverse reactions to diazepam.

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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

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Explanation

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Correct Answer is C

Explanation

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