A patient is admitted with severe malnutrition. A central venous catheter is placed in the right subclavian vein and total parenteral nutrition (TPN) is started. What medical interventions may be initiated with the onset of hyperglycemia?
Adding insulin to the TPN
Discontinuing the infusion
Weaning from the TPN over a 6-hour period
Starting an infusion of 0.9% normal saline
The Correct Answer is A
A. Insulin can be added to the TPN to control blood sugar levels. TPN often leads to hyperglycemia, and insulin is commonly added to the solution to regulate glucose levels.
B. Discontinuing the infusion would not address the hyperglycemia and would risk nutrient deficiencies.
C. Weaning from TPN may be indicated when discontinuing the nutrition support, but it is not a direct intervention for hyperglycemia.
D. Starting an infusion of 0.9% normal saline would not address the hyperglycemia directly and may not be effective in managing the glucose levels.
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Related Questions
Correct Answer is ["A","C","D"]
Explanation
A. Support system: Spiritual beliefs often provide a supportive community and network of individuals that can help a person navigate illness and difficult situations. A strong support system can positively influence a person's health and well-being.
B. Knowledge that illness is a punishment: This belief is typically negative and may lead to feelings of guilt or despair, which can have a detrimental effect on health. It does not support overall well-being.
C. Endurance of extreme stress: Spiritual beliefs can provide a sense of purpose and strength that helps individuals cope with stress and adversity, promoting resilience in the face of challenges.
D. Positive emotions: Spirituality can foster hope, gratitude, and a sense of peace, all of which can enhance emotional well-being and improve overall health outcomes.
E. Diet: While some spiritual beliefs may have dietary guidelines, not all spiritual practices directly influence diet in a way that enhances health. It is more common for spirituality to affect emotional and mental well-being.
Correct Answer is A
Explanation
A. A high fat, low carbohydrate formula is most appropriate for patients with poorly controlled diabetes mellitus, as it helps stabilize blood glucose levels while still providing necessary nutrition.
B. A concentrated calorie formula may not be appropriate for this patient as it could lead to hyperglycemia due to increased glucose intake.
C. Whole proteins and glucose polymers might increase the glucose load and exacerbate poor blood sugar control.
D. While low sodium is important for many conditions, it is not the primary concern for managing poorly controlled diabetes mellitus in the context of enteral nutrition.
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