A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux. Which of the following instructions should the nurse include?

The nurse should plan to change the IV tubing for the TPN solution every 72 hours. This is necessary to maintain the sterility of the system and minimize the risk of infection. TPN solutions are prone to bacterial growth, and changing the tubing regularly helps prevent contamination.

Removing TPN from the refrigerator 5 minutes before infusing it is not necessary. TPN solutions are typically stored in the refrigerator to maintain their stability and prevent spoilage. It should be brought to room temperature over a longer period of time, usually 30-60 minutes, before administration.

Discarding the remaining TPN solution that is still infusing after 24 hours is unnecessary. TPN solutions can typically be infused for up to 24 hours without compromising their safety and efficacy. However, it is important to monitor the solution closely for any signs of contamination or degradation, and if any concerns arise, the nurse should consult with the healthcare provider.

Changing the dressing around the IV site weekly is not specific to TPN administration. Dressing changes for peripheral IV sites are typically performed according to facility protocols and the condition of the site, but they are not necessarily done on a weekly basis. The frequency of dressing changes depends on factors such as the type of dressing used, the patient's condition, and any signs of infection or dislodgement.

The expected finding in an older adult client with dysphagia and dehydration is tachycardia. Tachycardia, an increased heart rate, is a common finding in dehydration as the body tries to compensate for the decreased fluid volume.
The other choices (hypertension, distended neck veins, and decreased respiratory rate) are not typically associated with dehydration in this context.
here's an explanation of why these choices are incorrect:
1. Hypertension: Dehydration usually leads to a decrease in blood volume, resulting in low blood pressure rather than hypertension. Hypertension is not a typical finding in dehydration.
2. Distended neck veins: Dehydration causes a decrease in blood volume, which results in decreased venous return to the heart. Consequently, distended neck veins would not be an expected finding.
3. Decreased respiratory rate: Dehydration itself does not directly affect respiratory rate. However, severe dehydration can lead to electrolyte imbalances, such as hyponatremia (low sodium levels), which can affect brain function and potentially lead to changes in respiratory rate. However, decreased respiratory rate is not a common finding in dehydration alone.
It's important to remember that dehydration can have various signs and symptoms, including dry mucous membranes, decreased urine output, increased thirst, dry skin, dizziness, and confusion.