A patient on mechanical ventilation is receiving total parenteral nutrition (TPN). Which statement is true?

The patient's head should remain elevated at 45 degrees to avoid aspiration.

TPN is preferred over the use of enteral feeding to avoid the complication of aspiration.

Lipid intake should be maintained at greater than 2 g/kg/day.

Excessive calorie intake can cause an increase in PaCO2

Answer and Explanation

The Correct Answer is D

A. The head of the bed should be elevated to at least 30 degrees to reduce the risk of aspiration, not 45 degrees.
B. Enteral feeding is typically preferred over TPN because it preserves gut integrity and reduces the risk of complications such as infections.
C. Lipid intake should generally be monitored and controlled, but greater than 2 g/kg/day is not recommended and may lead to complications such as hyperlipidemia.
D. Excessive calorie intake, particularly from carbohydrates, can increase carbon dioxide production, leading to a rise in PaCO2 levels in mechanically ventilated patients.

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Correct Answer is B

Explanation

A. Autonomy refers to respecting the patient’s right to make their own decisions. While important, it is not the ethical principle that guides the nurse's decision to report the situation to Adult Protective Services.
B. Nonmaleficence refers to the duty to do no harm. Reporting the neglect of the client to Adult Protective Services is consistent with preventing further harm and ensuring the client’s safety.
C. Justice refers to fairness and equal treatment. While the nurse is working to protect the client, the situation involves more than just fairness, making nonmaleficence the more applicable principle.
D. Fidelity refers to loyalty and keeping promises, but it does not specifically guide the nurse’s action in this situation.

A. Limit all nutrients to account for altered renal excretion. B. Ensure an adequate amount of protein to prevent catabolism. C. Increase fluids to replace losses. D. Encourage potassium-rich foods to replace losses.

Correct Answer is B

Explanation

A. Limiting all nutrients is not recommended for patients on dialysis. While certain nutrients like potassium and phosphorus may need to be restricted, dialysis patients usually require adequate nutrition, especially protein, to support healing and prevent malnutrition.
B. Ensuring an adequate amount of protein is correct. Dialysis patients often experience protein loss through dialysis and need additional protein to prevent catabolism and muscle wasting. Protein intake should be carefully monitored to meet their nutritional needs while avoiding excessive waste buildup.
C. Increasing fluids is not typically advised for dialysis patients, as they often have fluid restrictions due to reduced kidney function and the risk of fluid overload.
D. Encouraging potassium-rich foods is not advisable for patients with renal disease, particularly if they are on dialysis, as they often have issues with potassium retention, which could lead to dangerous hyperkalemia.

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A patient on mechanical ventilation is receiving total parenteral nutrition (TPN). Which statement is true?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Which nutritional interventions is a priority for the patient with renal disease who is receiving dialysis?

Correct Answer is B

Explanation

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