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 A

Explanation

A. Leukocytosis refers to an elevated white blood cell (WBC) count, typically above the normal range (approximately 4,000 to 10,000 WBCs per microliter of blood). A count of 22,000 indicates leukocytosis, which may be due to infection, inflammation, stress, or other conditions.
B. A left shift refers to an increase in immature white blood cells, particularly neutrophil precursors, in the bloodstream. It often indicates an acute infection or inflammatory response. While the WBC count of 22,000 may suggest a left shift, it does not confirm it without further analysis of the differential count of the WBCs.
C. Erythrocytosis is an increase in red blood cells (RBCs), not white blood cells. Therefore, this option is incorrect. A high WBC count does not indicate changes in red blood cell levels.
D. Neutropenia refers to a decreased number of neutrophils, which are a type of white blood cell. Given the WBC count of 22,000, neutropenia is not applicable and is therefore incorrect.

A. "I will add high-protein foods or finger foods to my diet" B. 1 will drink up to 1 liter of liquid each day" C. "I will be sure to eat three large meals daily" D. "I will choose a diet high in fat to help gain weight"

Correct Answer is A

Explanation

A. This statement indicates a good understanding of nutritional needs. High-protein foods are essential for maintaining muscle mass and supporting immune function, particularly for individuals with HIV. Finger foods can also help if the client has a reduced appetite or difficulty with larger meals.
B. While hydration is important, 1 liter may not be sufficient for overall health, especially if the client is experiencing weight loss or other symptoms of dehydration. The nurse would typically recommend a higher intake, considering fluid needs can vary based on activity level and overall health.
C. This statement may not be optimal for weight gain. For someone struggling with weight maintenance, smaller, more frequent meals may be more beneficial than three large meals. Large meals might lead to fullness and decrease overall caloric intake, which can hinder weight gain efforts.
D. While fats can provide a high caloric density, a diet excessively high in unhealthy fats is not ideal. It’s important to focus on healthy fats (like avocados, nuts, and olive oil) rather than just increasing fat intake indiscriminately.

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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)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a WBC count of 22,000. The nurse should conclude that the client has which of the following?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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