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?
Urinary ketones.
Serum protein.
Serum osmolarity.
Capillary glucose.
The Correct Answer is D
Correct answer: D
Choice A
Urinary ketones are not most important. Monitoring urinary ketones can provide information about the utilization of glucose and fat as energy sources. However, it is not the primary lab value to monitor in TPN administration.
Choice B
Serum protein is not most important. Monitoring serum protein levels is important to assess nutritional status, but it might not be as immediate a concern as serum osmolarity.
Choice C
Serum osmolarity reflects the concentration of particles (such as electrolytes, glucose, and other solutes) in the blood. Monitoring serum osmolarity is important to prevent complications related to fluid and electrolyte imbalances that can arise from the administration of TPN. Blood glucose levels (option D) are more critical because TPN can significantly impact glucose metabolism
Choice D
When caring for a client receiving total parenteral nutrition (TPN), the nurse’s priority is to monitor blood glucose levels. TPN can affect blood glucose, and observing for signs of hyperglycemia or hypoglycemia is crucial. Additionally, administering insulin as directed based on blood glucose levels is essential.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A
Drinking a litre of water during and after running is not appropriate: While hydration is important, consuming plain water might not be sufficient to address electrolyte imbalances that can contribute to leg cramps. Drinking excessive amounts of water without electrolyte replacement can even lead to a dilution of electrolyte levels.
Choice B
Consuming a sports drink before and during training is appropriate. Sports drinks are formulated to provide not only hydration but also electrolytes like sodium, potassium, and sometimes magnesium. These electrolytes are important for proper muscle function and can help prevent cramps. Consuming a sports drink before and during training can help maintain electrolyte balance and reduce the risk of leg cramps.
Choice C
Eating a high carbohydrate meal after running is not appropriate. Carbohydrates are important for refuelling muscles after exercise, but this recommendation doesn't directly address the issue of leg cramps during training. Electrolytes like sodium, potassium, and magnesium play a role in muscle function and can help prevent cramps.
Choice D
Avoid drinking alcohol forty-eight hours before training is not appropriate. While avoiding alcohol before training is generally a good idea for hydration and performance reasons, it doesn't specifically address the issue of leg cramps. Electrolyte balance is more directly related to muscle cramping.
Correct Answer is C
Explanation
Choice A
Providing pamphlets about heart-healthy diet selections should not be implemented. Providing information is important, but it might not be as effective if the client is strongly resistant. Engaging in a conversation first can help tailor the information to the client's needs.
Choice B
Referring the client to a dietitian for nutrition education should not be implemented. A dietitian can provide valuable education, but it might be more beneficial to address the client's concerns and resistance before making the referral.
Choice C
Discussing client's concerns about the change in diet should be implemented. When a client is resistant or unwilling to make changes to their diet and lifestyle, it's important for the nurse to engage in open and empathetic communication. Option C, discussing the client's concerns about the change in diet, is the most appropriate initial response.
By engaging in a conversation with the client, the nurse can better understand the client's perspective, reasons for resistance, and potential barriers to making dietary changes. This approach allows the nurse to address the client's concerns, provide information, and work collaboratively to find solutions that might be more acceptable to the client.
Choice D
Suggesting exercise as an alternative to increase HDL levels should not be implemented. Exercise is important for heart health, but it's important to address the client's resistance to dietary changes first. Additionally, dietary changes and exercise can work together to improve overall heart health.
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