Orders were written for a client to be weaned off of total parenteral nutrition (TPN) and started on a low-residue diet. The TPN solution has been infusing at a continuous rate of 90 ml/hr for three weeks. Which of the following orders should the nurse anticipate next?

Decrease the TPN rate to 60 ml/hr

Replace TPN infusion with an intravenous dextrose solution

Begin infusion of 0.9% normal saline at 30 ml/hr

Discontinue TPN infusion

Answer and Explanation

The Correct Answer is B

A. Decrease the TPN rate to 60 ml/hr: Gradually decreasing the TPN rate is a common practice, but it is typically done in conjunction with transitioning to another form of nutrition, not as a standalone order.
B. Replace TPN infusion with an intravenous dextrose solution: This is the correct choice. When weaning off TPN, it is important to prevent hypoglycemia by replacing the TPN with a dextrose solution to maintain blood glucose levels while transitioning to oral or enteral feeding.
C. Begin infusion of 0.9% normal saline at 30 ml/hr: While saline may be used for hydration, it does not address the need to manage blood glucose levels during the transition from TPN.
D. Discontinue TPN infusion: Discontinuing TPN abruptly can lead to complications such as hypoglycemia. It is important to gradually taper off TPN while replacing it with a dextrose solution.

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Correct Answer is C

Explanation

A. Imitation of the lining of the stomach: This is not a common complication related to calcium supplementation or fluid intake.
B. Mobilization of calcium from bones: Drinking fluids does not affect the mobilization of calcium from bones; this is more related to bone health and calcium metabolism.
C. Developing kidney stones: Adequate fluid intake helps prevent kidney stones, which can form when there is excess calcium in the urine. High calcium levels can lead to stone formation if not properly managed with sufficient hydration.
D. Developing muscle cramps: While calcium plays a role in muscle function, fluid intake primarily helps with kidney function and preventing stone formation rather than directly preventing muscle cramps.

A. A 58-year-old client who uses antacids every day B. A 48-year-old client with an anxiety disorder C. A 68-year-old client with chronic lung disease D. A 28-year-old client with salicylate intoxication

Correct Answer is C

Explanation

A. A 58-year-old client who uses antacids every day: Antacids primarily affect gastric acid levels and are not typically associated with respiratory acidosis. They might affect metabolic balance but not respiratory acidosis.
B. A 48-year-old client with an anxiety disorder: Anxiety disorders are more commonly associated with respiratory alkalosis due to hyperventilation, not respiratory acidosis.
C. A 68-year-old client with chronic lung disease: This is the correct choice because chronic lung diseases, such as chronic obstructive pulmonary disease (COPD), often impair CO2 elimination, leading to respiratory acidosis due to CO2 retention.
D. A 28-year-old client with salicylate intoxication: Salicylate intoxication is often associated with metabolic acidosis, and initially, it can cause respiratory alkalosis due to hyperventilation, rather than respiratory acidosis.

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Orders were written for a client to be weaned off of total parenteral nutrition (TPN) and started on a low-residue diet. The TPN solution has been infusing at a continuous rate of 90 ml/hr for three weeks. Which of the following orders should the nurse anticipate next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education in a community setting to several clients taking daily calcium supplements and encourages them to drink 2,500 mL of fluid daily. The nurse explains that this intervention is important to prevent which complication?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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