While caring for a client receiving total parenteral nutrition (TPN), it is most important for the nurse to monitor which of the client's lab values?

Serum protein.

Serum osmolarity.

Urinary ketones.

Capillary glucose.

Answer and Explanation

The Correct Answer is D

A. Serum protein is an indicator of the client’s overall nutritional status, but it is not as immediately critical to monitor as glucose levels in clients receiving TPN. Protein levels change more slowly over time and are not an acute concern.

B. While serum osmolarity is important in evaluating hydration status and electrolyte balance, it is not the primary lab to monitor during TPN administration. Glucose fluctuations are more likely to cause immediate complications.

C. Urinary ketones are typically monitored in clients with diabetic ketoacidosis (DKA), not in clients receiving TPN. Ketones are a byproduct of fat metabolism and are not a priority in TPN management.

D. Capillary glucose is the most important lab to monitor in clients on TPN because TPN solutions contain high amounts of glucose, which can lead to hyperglycemia. Monitoring glucose levels helps prevent complications such as hyperglycemia or hypoglycemia and is critical in managing the client's metabolic response to TPN.

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Correct Answer is D

Explanation

Choice A: Nasogastric tube insertion may be indicated in the management of a client with peptic ulcer disease (PUD) to assess bleeding, relieve gastric distention, or administer medications. However, in this scenario, the client's presentation with sudden severe upper abdominal pain, a tender and rigid abdomen, hypotension, and tachycardia suggests a potentially life-threatening condition that requires immediate intervention beyond nasogastric tube insertion.

Choice B: Iced saline lavage is not a standard procedure for managing peptic ulcer disease (PUD) or its complications. It is not the immediate intervention required for the client's presentation.

Choice C: Administration of pantoprazole (Protonix) IV, a proton pump inhibitor, is a relevant intervention for managing peptic ulcer disease (PUD), but it may not be the most immediate action needed for a client with sudden severe abdominal pain, hypotension, and tachycardia. More urgent interventions are required.

Choice D: Emergency abdominal surgery is the most appropriate and immediate intervention for a client with sudden severe upper abdominal pain, a tender and rigid abdomen, hypotension, and tachycardia. These signs and symptoms may indicate a perforated peptic ulcer, which is a surgical emergency requiring prompt exploration and repair of the perforation to prevent peritonitis and sepsis.

A. Medication teaching concerning thyroid hormones B. Client and family referral to a hospice. C. Psychological counseling to address body image changes. D. Preoperative and postoperative teaching for adrenalectomy.

Correct Answer is D

Explanation

Choice A: Medication teaching concerning thyroid hormones is not directly related to the care of a client with pheochromocytoma. Pheochromocytoma primarily involves the adrenal glands and excessive secretion of catecholamines.

Choice B: Referral to a hospice is not a relevant goal for a client diagnosed with pheochromocytoma. Hospice care is typically provided for clients with advanced, life- limiting illnesses, and pheochromocytoma can often be treated or managed.

Choice C: Psychological counseling to address body image changes is not the primary goal for a client with pheochromocytoma. While psychological support may be beneficial, the primary focus should be on addressing the physiological effects and treatment of pheochromocytoma.

Choice D: Preoperative and postoperative teaching for adrenalectomy is the most relevant goal for a client with pheochromocytoma. Surgical removal of the tumor (adrenalectomy) is the primary treatment for pheochromocytoma, and education about the procedure, preparation, and postoperative care is essential to ensure a successful outcome.

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While caring for a client receiving total parenteral nutrition (TPN), it is most important for the nurse to monitor which of the client's lab values?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

When the nurse is designing a plan of care for a client diagnosed with pheochromocytoma, a goal statement should be prepared that relates to which topic?

Correct Answer is D

Explanation

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