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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: Shaking the MDI before use is correct technique as it ensures that the medication is properly mixed.

Choice B reason: Exhaling before using the MDI is proper technique as it prepares the lungs for inhalation of the medication.

Choice C reason: Inspiring rapidly when dispensing the medication is incorrect because it can cause the medication to deposit in the mouth or throat rather than reaching the lungs.

Choice D reason: Holding the breath for 10 seconds after inhaling the medication is correct technique as it allows the medication to settle in the lungs.

A. pH 7.46, PaCO2 30, HCO3 24 B. pH 7.48, PaCO2 45, HCO3 29 C. pH 7.26, PaCO2 59, HCO3 30 D. pH 7.31, PaCO2 34, HCO3 18

Correct Answer is A

Explanation

Choice A reason: The lab results pH 7.46, PaCO2 30, HCO3 24 indicate respiratory alkalosis, which can occur due to hyperventilation. In pulmonary edema, the patient may hyperventilate to compensate for reduced oxygenation, leading to a decrease in carbon dioxide (PaCO2) and an increase in pH (alkaline).

Choice B reason: The lab results pH 7.48, PaCO2 45, HCO3 29 indicate metabolic alkalosis with partial compensation. This is not consistent with hyperventilation in pulmonary edema, where respiratory alkalosis is more likely.

Choice C reason: The lab results pH 7.26, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This finding suggests hypoventilation, which is not expected in a patient hyperventilating due to pulmonary edema.

Choice D reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis with partial compensation. This is not typical in a patient with hyperventilation and pulmonary edema.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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