The nurse is providing care to a patient admitted with an exacerbation of Crohn's disease and a history of diabetes. The patient is receiving total parenteral nutrition (TPN) through a central venous access device. Which intervention will the nurse implement while caring for this patient?
Administer lipid injectable emulsion with TPN every day based on albumin results.
Disconnect IV tubing and add regular insulin to TPN bag based on the sliding scale results.
Maintain aseptic technique when changing tubing or parenteral nutrition bag.
Administer dextrose infusion through a separate tubing three hours before discontinuing TPN.
The Correct Answer is C
Choice A reason: Administering lipid injectable emulsion with TPN every day based on albumin results is not the priority intervention. While lipid emulsions may be part of TPN, the focus should be on maintaining aseptic technique to prevent infection.
Choice B reason: Disconnecting IV tubing and adding regular insulin to the TPN bag based on sliding scale results is not appropriate. Insulin should be administered separately, and aseptic technique must be maintained to prevent contamination.
Choice C reason: Maintaining aseptic technique when changing tubing or the parenteral nutrition bag is crucial for preventing infection. Patients receiving TPN through a central venous access device are at high risk for infections, and strict aseptic technique is essential.
Choice D reason: Administering dextrose infusion through separate tubing three hours before discontinuing TPN is not a standard practice. The focus should be on proper administration and infection control practices.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: The patient being increasingly drowsy and hard to arouse is an urgent finding that should be reported immediately. This condition may indicate intracranial bleeding or other severe complications related to extremely low platelet count (10,000/mm³) in idiopathic thrombocytopenic purpura (ITP). Immediate medical intervention is required to prevent further deterioration.
Choice B reason: Red, raised purpura on the patient's feet and hands is a concerning finding indicative of significant thrombocytopenia, but it is not as immediately life-threatening as decreased consciousness. It should still be monitored and managed, but the priority is the patient's level of consciousness.
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.
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