The nurse is preparing to hang the client's next bag of Total Parenteral Nutrition (TPN) and observes fat globules rising to the top of the solution. What action should the nurse take?
Run the bag under warm water to melt the globules.
Call the pharmacy to get a new bag of TPN.
Do nothing, as fat globules are expected to rise to the top of the TPN solution.
Roll the bag of solution gently to redistribute the fat.
The Correct Answer is B
Choice A Reason
Running the bag under warm water to melt the globules is not recommended. Applying heat could compromise the sterility and integrity of the solution. TPN solutions are carefully balanced and sterile, and any manipulation involving temperature changes could lead to contamination or nutrient degradation.
Choice B Reason
Observing fat globules at the top of the TPN solution is a sign that the emulsion may be compromised. The nurse should not administer this TPN solution and should call the pharmacy for a replacement. TPN solutions should be homogenous with no visible separation or fat globules to ensure the patient receives the correct nutrition and to prevent complications.
Choice C Reason
Doing nothing is not an appropriate action. Fat globules indicate that the solution has separated, which can lead to an unstable emulsion and potential harm if infused. The nurse's responsibility is to ensure the safety and efficacy of the treatment, which includes verifying that TPN solutions are properly mixed.
Choice D Reason
Rolling the bag gently to redistribute the fat is not a safe practice. While gentle agitation can be used for some medications, it is not appropriate for TPN solutions with visible fat globules. This could further destabilize the emulsion and does not address the underlying issue of separation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason:
Obesity is a significant risk factor for gout. It can lead to increased production and decreased excretion of uric acid, which in turn can cause gout attacks. The normal body mass index (BMI) range is 18.5 to 24.9, and a BMI of 30 or above is considered obese.
Choice B reason:
Regular consumption of beer can increase the risk of gout. Beer is high in purines, which the body breaks down into uric acid, and alcohol can reduce the excretion of uric acid by the kidneys. Moderation in alcohol consumption is advised, with the recommendation being up to one drink per day for women and up to two drinks per day for men.
Choice C reason:
Thiazide diuretics are associated with an increased risk of gout. They can decrease the kidney's ability to remove uric acid from the body, leading to its accumulation. When prescribing thiazide diuretics, healthcare providers often monitor uric acid levels and consider alternative medications if the patient has a history of gout.
Choice D reason:
Depression is not directly identified as a risk factor for developing gout. However, some lifestyle factors associated with depression, such as poor diet and inactivity, could indirectly increase the risk.
Choice E reason:
Hypertension is a known risk factor for gout. High blood pressure can impair kidney function, which is responsible for excreting uric acid, thus leading to hyperuricemia and gout. The normal range for blood pressure is considered to be below 120/80 mmHg.
Correct Answer is A
Explanation
Choice a reason:
Decreasing intake of vitamin K-rich foods is not recommended for the prevention of osteoporosis. Vitamin K is essential for bone health because it helps in the synthesis of proteins required for bone formation and mineralization. A deficiency in vitamin K can lead to weakened bone structure and increased risk of fractures. Foods rich in vitamin K include green leafy vegetables like spinach, kale, and broccoli, which should be a part of a balanced diet aimed at preventing osteoporosis.
Choice b reason:
Reducing sodium intake can be beneficial for bone health. Excessive sodium consumption can cause calcium loss through urine, which may contribute to bone demineralization and increase the risk of osteoporosis. The American Heart Association recommends no more than 2,300 milligrams a day and moving toward an ideal limit of no more than 1,500 mg per day for most adults.
Choice c reason:
Avoiding carbonated soda, especially those containing phosphoric acid, is advisable for osteoporosis prevention. Some studies suggest that phosphoric acid in soda can leach calcium from bones and decrease calcium absorption, potentially weakening bones and increasing the risk of osteoporosis.
Choice d reason:
Limiting caffeinated beverages is a prudent step in preventing osteoporosis. Caffeine can interfere with calcium absorption and lead to its increased excretion in urine. It is generally recommended to limit caffeine intake to about 400 mg per day, equivalent to around four 8-ounce cups of brewed coffee.
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