The nurse is initiating Total Parenteral Nutrition (TPN) to a postoperative patient after a proctocolectomy. What actions will the nurse initiate to begin this therapy when caring for this patient?
Start with a rapid infusion rate to meet the patient's nutritional needs as quickly as possible.
Initiate the infusion slowly and monitor the patient's fluid and glucose tolerance.
Change the rate of administration every 4 hours based on serum electrolyte values.
Increase the rate of infusion at mealtimes to mimic the circadian rhythm of the body.
The Correct Answer is B
Choice A reason: Starting with a rapid infusion rate to meet the patient's nutritional needs as quickly as possible is not recommended. Rapid infusion can cause complications such as fluid overload, hyperglycemia, and electrolyte imbalances. It is important to start TPN at a slow rate and gradually increase it as tolerated.
Choice B reason: Initiating the infusion slowly and monitoring the patient's fluid and glucose tolerance is the appropriate action. This allows the nurse to assess the patient's response to TPN, prevent complications, and make necessary adjustments to the infusion rate.
Choice C reason: Changing the rate of administration every 4 hours based on serum electrolyte values is not a standard practice. The rate should be adjusted based on the patient's overall tolerance and clinical condition, rather than frequent changes.
Choice D reason: Increasing the rate of infusion at mealtimes to mimic the circadian rhythm of the body is not appropriate for TPN. TPN is typically administered continuously over 24 hours to provide steady nutrition and prevent complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Fever is not a common side effect of albuterol. It may indicate an infection or another underlying condition that should be evaluated separately.
Choice B reason: Bruising is not associated with albuterol use. Bruising may be related to other medications or underlying conditions affecting coagulation.
Choice C reason: Polyuria, or increased urination, is not a typical side effect of albuterol. It is more commonly associated with conditions such as diabetes or diuretic use.
Choice D reason: Palpitations are a known side effect of albuterol due to its stimulating effect on the heart. Patients should be informed about this potential side effect and advised to report any persistent or severe palpitations to their healthcare provider.
Correct Answer is C
Explanation
Choice A reason: The lab results pH 7.26, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This finding is inconsistent with the expected results for a patient with small bowel obstruction and nasogastric suction, which typically leads to metabolic alkalosis due to loss of gastric acid.
Choice B reason: The lab results pH 7.46, PaCO2 30, HCO3 24 suggest a slightly alkaline state with normal bicarbonate levels, which could indicate respiratory alkalosis with compensation. However, for a patient with a small bowel obstruction and nasogastric suction, this is less likely.
Choice C reason: The lab results pH 7.48, PaCO2 42, HCO3 29 indicate metabolic alkalosis. This is a common finding in patients with small bowel obstruction who have been on nasogastric suction, which removes stomach acids and leads to an increase in bicarbonate levels. The elevated pH and bicarbonate levels are consistent with this condition.
Choice D reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis. This finding is inconsistent with the expected results for a patient with small bowel obstruction and nasogastric suction, which typically leads to
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