The nurse is caring for a client receiving total parenteral nutrition (TPN). The nurse understands that the best explanation for utilizing TPN is to:

assist clients who are unable to eat but have active GI function.

give short term nutrition after a surgical procedure.

provide all of the client's nutritional needs in a hypertonic solution.

prevent complications after a laparotomy for a bowel obstruction.

Answer and Explanation

The Correct Answer is C

C. TPN does provide all of the client's nutritional needs, including carbohydrates, proteins, fats, vitamins, minerals, and electrolytes, in a hypertonic solution. The hypertonicity of the solution is necessary to prevent fluid overload and ensure compatibility with the vasculature. The hypertonic solution allows for higher nutrient concentrations to be delivered without exceeding vascular capacity.
A. TPN is indicated for clients who are unable to tolerate enteral nutrition (feeding through the gastrointestinal tract) or have impaired absorption, digestion, or utilization of nutrients despite having active GI function.
B. TPN may be used temporarily after a surgical procedure if the client is unable to tolerate oral or enteral feeding or if enteral nutrition is contraindicated due to the surgical site or condition. However, TPN is not limited to short-term use after surgery and may be required for an extended period in clients with chronic conditions or prolonged inability to tolerate enteral nutrition.
D. TPN may be used in some cases after a laparotomy for a bowel obstruction, particularly if enteral nutrition is contraindicated or if the client is unable to tolerate oral intake. However, TPN is not primarily used to prevent complications after surgery but rather to provide nutritional support when enteral feeding is not feasible or sufficient.

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Correct Answer is C

Explanation

C. Decrease the rate to 27.1 mL/hr until the new bag is brought to the unit: This option is a suitable approach to conserve the remaining TPN solution until the new bag arrives. By halving the infusion rate, the remaining volume of TPN will last longer, ensuring the client continues to receive some nutrition and fluid support while awaiting the delivery of the new bag.
A. While it's important to inform the healthcare team about the low volume of TPN remaining, it may not require immediate physician intervention unless the situation worsens or alternative actions need to be taken.
B. Notifying the pharmacy when the bag is empty is a reasonable action, as they can prepare and deliver the next infusion bag promptly. However, it does not address the immediate need for fluid and nutrition replacement.
D. D10W (dextrose 10% in water) can help prevent hypoglycemia and provide some energy, but it does not provide the full nutritional support that TPN does. However, it can be a reasonable short- term measure while waiting for the replacement TPN bag.

A. "I'm so glad I will be able to drink orange juice while I'm taking these medications." B. "While I'm taking these medications, my bowel movements could be black." C. "I'll include more calcium and vitamin D in my diet to prevent osteoporosis." D. "I have a medicine at home to take when I start having loose stools."

Correct Answer is B

Explanation

B. Bismuth subsalicylate, one of the medications prescribed for peptic ulcers, can cause blackening of the stools. This discoloration is harmless and temporary but is an important side effect to be aware of.
A. Citrus juices, including orange juice, can exacerbate symptoms of peptic ulcers due to their acidic nature. Therefore, it would not be appropriate for the client to consume orange juice while taking famotidine and bismuth subsalicylate.
C. Osteoporosis is not a known side effect or concern associated with these medications.
D. Constipation and not diarrhea, is a potential side effect of bismuth subsalicylate.

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The nurse is caring for a client receiving total parenteral nutrition (TPN). The nurse understands that the best explanation for utilizing TPN is to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client receiving a TPN Infusion running at 54.2 mL/hr and there is only 25 mL remaining in the bag. The next Infusion bag has not been brought to the unit. Which action would be appropriate?

Correct Answer is C

Explanation

The nurse teaches a client newly diagnosed with a peptic ulcer about the prescribed medications famotidine and bismuth subsalicylate. Which statement made by the client indicates that the teaching was effective?

Correct Answer is B

Explanation

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