A charge nurse is teaching a newly licensed nurse about the administration of total parenteral nutrition. Which of the following statements should the charge nurse include?
"You will need to change the IV dressing site once per week."
"You will need to warm the solution in the microwave before administration."
"You will need to weigh the client twice per week."
"You will need to monitor the client's electrolytes daily."
The Correct Answer is D
Rationale:
A. "You will need to change the IV dressing site once per week.": Central line dressings for TPN are typically changed every 48–72 hours for gauze or every 5–7 days for transparent dressings, or sooner if the dressing becomes damp, loose, or soiled, to reduce infection risk.
B. "You will need to warm the solution in the microwave before administration.": TPN solutions should never be microwaved due to the risk of uneven heating and nutrient degradation. They should be administered at room temperature.
C. "You will need to weigh the client twice per week.": Clients receiving TPN require daily weights to monitor fluid balance, nutritional status, and detect fluid retention or dehydration promptly. Twice-weekly measurements are insufficient for close monitoring.
D. "You will need to monitor the client's electrolytes daily.": TPN can cause rapid changes in fluid and electrolyte balance, so daily electrolyte monitoring allows timely adjustments to prevent complications such as hypo- or hypernatremia, hypokalemia, and metabolic imbalances.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["140"]
Explanation
Calculation:
- Convert the client's current weight from kilograms (kg) to pounds (lbs).
Current weight (lbs) = Patient weight (kg) x Conversion factor (lbs/kg)
= 75 kg x 2.2 lbs/kg
= 165 lbs.
- Calculate the total weight loss over 25 weeks.
Total weight loss (lbs) = Weight loss per week (lbs) x Number of weeks
= 1 lb/week x 25 weeks
= 25 lbs.
- Calculate the expected goal weight in pounds (lbs).
Goal weight (lbs) = Current weight (lbs) - Total weight loss (lbs)
= 165 lbs - 25 lbs
= 140 lbs.
Correct Answer is ["C","D","E","F"]
Explanation
Rationale:
A. Inform the client she will need to formula feed her newborn until she has received antibiotics for 24 hr: Most antibiotics used to treat postpartum endometritis are safe for breastfeeding. Temporary formula feeding is not routinely required.
B. Request a prescription for terbutaline from the provider: Terbutaline is a tocolytic used to suppress preterm labor, which is not indicated postpartum. It does not treat infection or uterine complications.
C. Monitor the height and tone of the client's fundus: Assessing the uterus for firmness and position helps detect uterine atony or worsening infection. Changes in fundal height or tone can indicate retained products of conception or hemorrhage.
D. Instruct the client to wash her hands before and after changing her perineal pad: Hand hygiene reduces the risk of introducing or spreading bacteria to the uterus or perineal area, which is critical when postpartum infection is present.
E. Encourage the client to maintain a semi-Fowler's position to enhance uterine drainage: Semi-Fowler’s positioning promotes drainage of lochia, decreases uterine congestion, and supports recovery from endometritis by reducing bacterial proliferation in pooled fluid.
F. Obtain a culture specimen of the lochia from the client's perineal pad using a sterile swab: A culture helps identify the causative organism of endometritis, allowing the provider to tailor antibiotic therapy effectively.
G. Initiate contact precautions: Endometritis is not a highly transmissible condition; standard precautions, including hand hygiene, are sufficient unless another communicable infection is identified.
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