The nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which finding(s) should alert the nurse that further assessment is needed? (Select all that apply.)

Redness at intravenous site.

Generalized nonpitting edema.

Frequent productive cough.

Hypoactive bowel sounds in all 4 quadrants.

Urinary output greater than 30 mL per hour.

Answer and Explanation

Correct Answer : A,B,C

Choice A: Redness at the intravenous site may indicate infection or phlebitis, which are complications of TPN.

Choice B: Generalized nonpitting edema may indicate fluid overload, which can occur due to the high osmolarity of TPN.

Choice C: Frequent productive cough may indicate pulmonary edema or aspiration, which are also potential complications of TPN.

Choice D: Hypoactive bowel sounds in all 4 quadrants are not necessarily abnormal, as TPN bypasses the gastrointestinal tract.

Choice E: Urinary output greater than 30 mL per hour is within the normal range and indicates adequate renal function.

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Correct Answer is C

Explanation

Choice A: Bread is generally considered a suitable food choice for individuals with cholelithiasis and is not typically associated with exacerbating symptoms or gallstone formation.

Choice B: Beef broth is a liquid and does not contain the same types of fats and cholesterol that can contribute to gallstone formation. It is not typically a concern for individuals with cholelithiasis.

Choice C: Ketchup is often high in sugar and can be made with vinegar, which may exacerbate symptoms in some individuals with cholelithiasis. It is advisable to omit or limit foods high in sugar and vinegar-based condiments.

Choice D: Ice cream, while high in fat, is generally tolerated by most individuals with cholelithiasis unless they experience specific dietary sensitivities. It is not typically recommended to omit ice cream from the diet unless advised by a healthcare provider.

A. I will withhold the antacid for now, and if you get indigestion, I will bring it back. B. CKD stresses your body to over-secrete gastric juices, and antacids help neutralize them. C. Your serum phosphate levels are up, and aluminum antacids prevent absorption of phosphates in foods. D. OK, I will let your healthcare provider know that you do not need the antacid.

Correct Answer is C

Explanation

Choice A: Withholding the antacid until the client gets indigestion is not appropriate because the primary purpose of aluminum hydroxide in CKD is to bind to phosphates in foods and reduce their absorption. It is not primarily used for indigestion.

Choice B: While CKD can lead to disturbances in gastric acid secretion, aluminum antacids are primarily used in CKD to control hyperphosphatemia by binding to phosphates in the gastrointestinal tract. Their role is not primarily related to gastric acid control.

Choice C: This response provides the most appropriate rationale. Aluminum antacids are often prescribed to CKD clients to prevent the absorption of dietary phosphates, which can contribute to hyperphosphatemia in CKD.

Choice D: Simply informing the healthcare provider that the client does not want to take the antacid is not the most informative response, as it does not address the rationale behind the medication use in CKD.

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The nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which finding(s) should alert the nurse that further assessment is needed? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A middle-aged client newly diagnosed with cholelithiasis is choosing the evening meal.What food choice should the nurse encourage the client to omit?

Correct Answer is C

Explanation

An adult male client with chronic kidney disease (CKD) is receiving aluminum hydroxide (Amphojel). He tells the nurse that since he does not have indigestion there is no need for him to take the antacid with his meals. Which response is best for the nurse to provide?

Correct Answer is C

Explanation

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