Before administering a parenteral nutrition solution through a central vein, the nurse should confirm information from which sources? (Select all that apply)

Solution label.

Healthcare provider's prescription.

Medication administration record.

Measured residual volume.

Dietician's progress notes.

Client's identification band.

Answer and Explanation

Correct Answer : A,B,F

Choice A: Confirming information from the solution label is essential to ensure that the correct parenteral nutrition solution is being administered.

Choice B: Confirming the healthcare provider's prescription is critical to verify the type, rate, and duration of the parenteral nutrition therapy, as well as any specific additives or electrolyte requirements.

Choice C: The medication administration record (MAR) is not directly related to parenteral nutrition, so it is not a primary source of information for this specific procedure.

Choice D: Measured residual volume is relevant for enteral nutrition administration but is not applicable to parenteral nutrition.

Choice E: The dietitian's progress notes may provide valuable information about the client's overall nutrition plan but are not the primary source for confirming the immediate administration of a specific parenteral nutrition solution.

Choice F: Confirming the client's identification band is essential to ensure the correct client receives the parenteral nutrition and to prevent errors in administration.

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Correct Answer is ["A","C","D"]

Explanation

Choice A: Positioning the client in the left lateral recumbent position allows the solution to flow by gravity into the sigmoid colon and rectum.

Choice B: Chilling the enema solution is not recommended because it can cause cramping, discomfort, and vasoconstriction, which may interfere with the client's fever assessment.

Choice C: Positioning the client in the left lateral recumbent position allows the solution to flow by gravity into the sigmoid colon and rectum.

Choice D: Inserting the lubricated tip of tubing 3 to 4 inches into the rectum prevents injury to the rectal mucosa and ensures proper placement of the tubing.

Choice E: Clamping the enema administration tubing after filling the enema bag is unnecessary and may cause air to enter the tubing, which can increase the risk of abdominal distension and gas pain.

A. An older female client who had a hip replacement yesterday and is notably pale with a Hemoglobin of 10.5 g/dl. B. An adult client with osteomyelitis of the ankle who refuses an IV restart that is needed to administer antibiotics. C. An elderly client with low back pain who removed the pelvic traction and repeatedly states a strong desire to go home. D. A young adult client with a closed reduction of a fractured femur who has been complaining of increasingly severe pain.

Correct Answer is D

Explanation

Choice A: The older female client who had a hip replacement yesterday and is notably pale with a hemoglobin of 10.5 g/dl likely needs attention, but the information provided does not indicate an urgent, life-threatening situation. Immediate intervention may not be necessary based on the information given.

Choice B: The adult client with osteomyelitis of the ankle who refuses an IV restart for antibiotics is concerning, but it does not represent an immediate life- threatening situation. The client's refusal should be addressed, but it may not require immediate attention.

Choice C: The elderly client with low back pain who removed pelvic traction and wants to go home may require assessment and intervention, but the information provided does not indicate an urgent, life-threatening situation. It may not be the first priority.

Choice D: The young adult client with a closed reduction of a fractured femur complaining of increasingly severe pain is the most concerning. Pain assessment and management are critical, and uncontrolled pain can lead to complications. This client should be attended to first to assess and address the pain.

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Before administering a parenteral nutrition solution through a central vein, the nurse should confirm information from which sources? (Select all that apply)

Nursing Test Bank

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Correct Answer is D

Explanation

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