The physician orders epoetin 30,000 units subcutaneously for anemia.

The medication is per the provided label on the supplemental exam sheet.

How many milliliters will the nurse administer? SEE LABEL #1 for drug availability.

Choice A rationale

While it is important to inform the physician about the delay in the TPN solution, the immediate priority is to maintain the patency of the central venous catheter and prevent hypoglycemia. Calling the MD should occur after taking steps to address the immediate risk.

Choice B rationale

Giving the patient a high-protein snack will not address the immediate issue of the TPN running out and the risk of hypoglycemia associated with the abrupt cessation of a high-glucose solution. TPN provides a significant amount of glucose, and suddenly stopping it can lead to a drop in blood sugar.

Choice C rationale

Hanging a bag of 10% dextrose solution (D10W) is the most appropriate immediate action. This will provide a continuous source of glucose to prevent hypoglycemia while waiting for the new TPN bag from the pharmacy. D10W is often used as a bridge solution in this situation. Normal blood glucose levels are typically 70-110 mg/dL.

Choice D rationale

Flushing the line and waiting for the pharmacy to supply the next bag without infusing any solution puts the patient at significant risk for hypoglycemia and can also lead to catheter occlusion. Maintaining a continuous infusion, even of D10W, is crucial. .

Choice A rationale

Stating that the patient drank most liquids without difficulty is a general observation but lacks specific details about the quantity consumed and the type of diet. It provides limited nutritional information.

Choice B rationale

Saying the patient ate all her lunch is brief but doesn't specify the type or amount of food consumed. "Lunch" can vary greatly in nutritional content, making this documentation less informative.

Choice C rationale

This documentation provides specific details about the patient's intake, including the percentage of the heart-healthy diet consumed (50%), indicating the amount of solid food, and the exact volume of liquids ingested (360 mL). It also notes the absence of difficulty, offering a more comprehensive nutritional picture.

Choice D rationale

Documenting assistance with feeding a liquid diet and frequent choking is important for safety but doesn't quantify the amount of liquid consumed or the patient's overall nutritional intake from the meal.