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 C
Explanation
Rationale:
A. Generativity vs self-absorption: This stage occurs in middle adulthood, typically between ages 40 and 65, when individuals focus on contributing to society, guiding the next generation, and creating a lasting legacy.
B. Trust vs mistrust: This is the first stage of Erikson’s theory, occurring in infancy (birth to 1 year). It centers on developing a sense of trust when basic needs are met consistently by caregivers.
C. Identity vs role confusion: This stage occurs during adolescence (approximately ages 12 to 18) and involves exploring personal values, beliefs, and goals to develop a stable sense of self. Success leads to identity formation, while failure results in role confusion.
D. Intimacy vs isolation: This stage takes place in young adulthood (approximately ages 20 to 40) and focuses on forming deep, committed relationships while balancing independence and emotional closeness.
Correct Answer is C
Explanation
Rationale:
A. Administer ondansetron to the client for nausea: Treating nausea is important for comfort, but it does not address the most urgent risk. Nausea is not immediately life-threatening compared with potential complications from medication overdose.
B. Obtain a blood glucose level: Checking blood glucose can provide useful information, but there is no indication of hypoglycemia or diabetes-related crisis in this scenario. It is not the priority action.
C. Implement seizure precautions for the client: The client has been doubling the bupropion dose, which significantly increases the risk of seizures, especially at doses above the prescribed maximum. Seizure precautions address an immediate life-threatening risk and should be the first intervention.
D. Obtain the client's weight: Monitoring weight is important for assessing nutritional status and the severity of depression, but it is not an immediate safety concern. Life-threatening risks, such as seizures, take priority.
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