Which of the following is are appropriate nursing interventions to ensure the safety of a patient who is receiving Total Parenteral Nutrition (TPN)? (Select all that apply)

TPN should flow through a filtered IV line

No other drugs should be infused through the TPN line

If TPN gets stopped or runs out, hang a bag of D10% W

TPN IV tubing and bag should be changed every 24 hrs

TPN should be administered through a central line

Answer and Explanation

Correct Answer : A,B,D,E

A.   Using a filtered IV line helps remove any particulate matter that could be present in the TPN solution, reducing the risk of complications such as phlebitis or embolism.
B.   TPN should have its own dedicated line to prevent incompatibilities and ensure the TPN solution is delivered without interference. Infusing other medications through the same line can lead to complications and reduce the effectiveness of TPN.
C.   If TPN gets stopped or runs out, a bag of 5% dextrose in water (D5W) should be hung to prevent hypoglycemia. D10% is too concentrated and can cause hyperglycemia.
D.   To minimize the risk of infection and maintain sterility, TPN bags and tubing should be replaced every 24 hours. This helps prevent bacterial growth in the TPN solution.
E.   TPN is typically administered through a central line because it allows for the infusion of hypertonic solutions that can irritate peripheral veins. Central lines provide better access to larger blood vessels, reducing the risk of complications.

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Correct Answer is D

Explanation

A. Neutropenia refers to an abnormally low level of neutrophils in the blood. This condition can result from various factors, including severe infections, bone marrow issues, or certain medications. However, in the context of a severe bacterial infection, you would expect an increase in neutrophils, not a decrease.
B. Anemia is a condition characterized by a lack of healthy red blood cells to carry adequate oxygen to the body’s tissues. While infections can lead to anemia, it is not a direct indicator of white blood cell production or response to a bacterial infection.
C. Leukopenia refers to a decrease in the overall white blood cell count. Like neutropenia, it indicates a reduced ability to fight infection, which is not consistent with a severe bacterial infection where the body is actively trying to produce more white blood cells.
D. A "left shift" indicates the presence of increased immature neutrophils (such as band cells) in the blood, which occurs when the bone marrow releases these cells into circulation in response to a severe infection. This reflects the body’s effort to combat an infection, typically seen in bacterial infections.

A. Premature Ventricular Contractions (PVC's) B. Respiratory Rate of 14 / min C. Circumoral cyanosis D. Retraction of sternal muscles E. SpO2 95%

Correct Answer is ["C","D"]

Explanation

A. Premature Ventricular Contractions (PVC's) (A) are related to cardiac activity and not directly indicative of respiratory function.
B. A respiratory rate of 14 breaths per minute is within the normal range for adults (12-20 breaths per minute). Therefore, this finding does not indicate a decline in respiratory status.
C. Circumoral cyanosis, which refers to a bluish discoloration around the mouth, indicates hypoxia and is a sign of deteriorating respiratory status. It suggests that the body is not getting enough oxygen, which is critical to monitor in an asthma attack.
D. Retractions, especially of the sternal muscles, are a sign of increased work of breathing and can indicate severe respiratory distress. This finding suggests that the patient is struggling to breathe effectively, indicating a decline in respiratory status.
E. An SpO2 of 95% is generally considered acceptable, especially in patients with asthma, as normal oxygen saturation levels typically range from 95% to 100%. While it is at the lower end of normal, it does not indicate an immediate decline in respiratory status.

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Which of the following is are appropriate nursing interventions to ensure the safety of a patient who is receiving Total Parenteral Nutrition (TPN)? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse in the Emergency Department (ED) is caring for a client who is having acute asthma attack. Which of the following assessments indicates that the respiratory status is declining?(Select all that apply)

Correct Answer is ["C","D"]

Explanation

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