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

Answer and Explanation

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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Correct Answer is D

Explanation

A. Blood pressure and heart rate are not indicators of opioid overdose; these values are within a normal range and do not suggest respiratory depression.
B. A temperature of 100.5°F and sleepiness are concerning but not life-threatening in isolation; the patient is easily aroused, which suggests they are not in respiratory distress.
C. A respiratory rate of 10 breaths/min is low, but if the patient is breathing deeply, they may still be compensating, and further monitoring is necessary.
D. A respiratory rate of 8 breaths/min with snoring is indicative of severe respiratory depression, a life-threatening side effect of opioid use. Immediate intervention is necessary.

A. Encourage the patient to deny the presence of the illness B. Encourage the patient to let the staff have total control of the patient's care. C. Foster trust in the interprofessional health care team. D. Inform the patient that everything will be all right

Correct Answer is C

Explanation

A. Encouraging denial of illness is incorrect as denial is not a healthy coping mechanism and may hinder treatment adherence.
B. Encouraging the patient to let staff have total control is incorrect because patient autonomy and involvement in care decisions enhance coping and emotional well-being.
C. Fostering trust in the interprofessional health care team is correct as it helps the patient feel supported and engaged in their care, reducing anxiety and promoting better coping strategies.
D. Telling the patient that everything will be all right is incorrect because it is a false reassurance that does not validate the patient's feelings or situation.

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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?

Nursing Test Bank

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