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: Performing weekly occult blood testing with gastric analysis is not typically required for managing IBD at home. This intervention is more invasive and usually performed under specific medical instructions rather than as a routine home care intervention.

Choice B reason: Discussing nutritional management with the inclusion of a high-protein, high-vitamin diet is crucial for patients with IBD. These patients often experience malnutrition due to poor absorption and increased nutritional needs during flare-ups. A high-protein, high-vitamin diet can help promote healing, maintain muscle mass, and prevent deficiencies.

Choice C reason: Leaving the ostomy site open to air for an hour each day when changing the appliance is not recommended. Ostomy sites need to be kept clean and protected to prevent infection and skin irritation.

Choice D reason: Instructing the patient and family on how to give medications through their G-tube is not relevant if the patient has an ileostomy. The focus should be on ostomy care and management

A. Ketoacidosis B. Pulmonary edema C. Atelectasis D. Hypoglycemia E. Hypokalemia

Correct Answer is ["B","D","E"]

Explanation

Choice A reason: Ketoacidosis is not a typical complication of hyperglycemic hyperosmolar syndrome (HHS) treatment. HHS usually occurs without significant ketoacidosis, and the focus is on managing hyperglycemia and dehydration.

Choice B reason: Pulmonary edema is a potential complication of rapid fluid replacement therapy. The increased fluid volume can overwhelm the heart's ability to pump effectively, leading to fluid accumulation in the lungs.

Choice C reason: Atelectasis is not a common complication of HHS treatment. It is more related to lung collapse or infection rather than fluid or insulin therapy.

Choice D reason: Hypoglycemia is a potential complication of continuous insulin infusion. Close monitoring of blood glucose levels is necessary to prevent blood sugar from dropping too low during treatment.

Choice E reason: Hypokalemia is a potential complication of insulin therapy. Insulin promotes the uptake of potassium into cells, which can reduce serum potassium levels. Monitoring and managing potassium levels is important during HHS treatment.

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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 creating a home care checklist for a patient diagnosed with inflammatory bowel disease (IBD) who is being discharged. The patient has an ileostomy from a previous surgery. What intervention will the nurse include in this plan?

Correct Answer is B

Explanation

Correct Answer is ["B","D","E"]

Explanation

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