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 B

Explanation

Choice A reason: While acute pain is a possibility in peripheral neuropathy, infection poses a more serious risk. The sensory deficits in peripheral neuropathy can lead to unnoticed injuries and subsequent infections, especially in the lower extremities.

Choice B reason: Infection is a major risk in patients with peripheral neuropathy due to the loss of sensation, which can result in unnoticed injuries that can become infected. Additionally, high blood sugar levels in diabetes can impair the immune response, making infections more likely and harder to heal.

A. "I can eat any foods I want before dialysis as long as I don't drink too much fluid." B. "I need to report any unusual changes in my access site, like redness or swelling." C. "I will need to check my blood pressure regularly to monitor for changes during dialysis." D. "I should contact my healthcare provider if I notice swelling in my hands, feet, or ankles." E. "I understand that hemodialysis will permanently cure my kidney disease."

Correct Answer is ["A","E"]

Explanation

Choice A reason: Eating any foods before dialysis as long as fluid intake is limited is incorrect. Patients undergoing hemodialysis need to follow specific dietary restrictions to manage electrolyte balance and prevent complications. A renal diet typically limits potassium, phosphorus, and sodium intake, in addition to fluid restrictions.

Choice B reason: Reporting any unusual changes in the access site, like redness or swelling, is correct. Changes at the access site can indicate infection or other complications and require immediate attention.

Choice C reason: Checking blood pressure regularly to monitor for changes during dialysis is correct. Blood pressure monitoring is essential during dialysis to detect hypotension or hypertension and adjust treatment accordingly.

Choice D reason: Contacting the healthcare provider if swelling in hands, feet, or ankles is noticed is correct. Swelling can indicate fluid overload or other complications that need to be addressed.

Choice E reason: Understanding that hemodialysis will permanently cure kidney disease is incorrect. Hemodialysis is a treatment that replaces kidney function but does not cure kidney disease. It manages symptoms and removes waste products from the blood.

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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

The nurse is caring for a patient with diabetes who is exhibiting signs and symptoms of peripheral neuropathy. What will the nurse identify as a risk for this patient?

Correct Answer is B

Explanation

The nurse is teaching a patient who is scheduled for hemodialysis about the process and potential complications. Which of the following statements by the patient indicates to the nurse the need for further teaching? (Select All That Apply)

Correct Answer is ["A","E"]

Explanation

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