A client is receiving total parenteral nutrition (TPN) via a subclavian central line, and the solution bag is nearly empty. The next bag of TPN is not available from the pharmacy. Which action should the nurse implement until the fluid arrives?

Slow the infusion rate and catch up the rate when the next TPN solution arrives.

Flush the central line with a heparin solution and cap the subclavian access.

Start 1,000 mL of 0.9% sodium chloride and monitor the serum glucose levels.

Follow the TPN with a 10% dextrose solution at the current rate of infusion.

Answer and Explanation

The Correct Answer is C

A. Slow the infusion rate and catch up the rate when the next TPN solution arrives. Slowing the

infusion rate may not provide adequate nutrition to the client, and catching up the rate later could lead to complications such as hyperglycemia or hypoglycemia.
B.   Flush the central line with a heparin solution and cap the subclavian access. Flushing the central line with heparin and capping the access would not provide the client with nutrition and could increase the risk of line occlusion.

C.   Start 1,000 mL of 0.9% sodium chloride and monitor the serum glucose levels. Starting 0.9% sodium chloride (normal saline) provides hydration and helps maintain electrolyte balance until the next bag of TPN is available. Monitoring serum glucose levels is essential to ensure that the client's glucose levels remain within the target range.
D.   Follow the TPN with a 10% dextrose solution at the current rate of infusion. Administering a 10% dextrose solution could lead to hyperglycemia, especially if the client does not require additional glucose. It is important to maintain appropriate glucose levels while awaiting the next bag of TPN.

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Correct Answer is C

Explanation

A. Bunions. While bunions can be uncomfortable and affect mobility, they are not directly related to nutritional status and may not require immediate nutritional assessment.
B. Sweaty palms. Sweaty palms can be a normal physiological response or related to factors such as anxiety or hyperhidrosis. It is not typically indicative of a nutritional issue.
C. Fatigue. Fatigue can be a symptom of various nutritional deficiencies or imbalances, including inadequate calorie intake, insufficient carbohydrate intake, or deficiencies in vitamins and
minerals such as iron or B vitamins. Further assessment is needed to determine the cause of the fatigue and whether it is related to the client's nutritional status.
D. Dry skin. Dry skin can also be a symptom of various issues, including dehydration, environmental factors, or skin conditions. While it can sometimes be associated with nutritional deficiencies, fatigue is a more concerning symptom in a professional dancer, as it can significantly affect performance and may indicate underlying nutritional issues.

A. Scrambled eggs with roasted peppers and onions, lean ham, and toast. B. Poached egg, bacon, biscuit and canned peaches in light syrup. C. Oatmeal with raisins and nuts, with skim milk and 1/2 grapefruit. D. Pancakes with blueberries and maple syrup, and a turkey sausage patty. E. Pancakes with blueberries and maple syrup, and a turkey sausage patty.

Correct Answer is C

Explanation

A. Scrambled eggs with roasted peppers and onions, lean ham, and toast. This meal contains lean protein from the eggs and ham, which is beneficial, but it lacks significant amounts of cancer- fighting nutrients found in fruits, vegetables, and whole grains.
B. Poached egg, bacon, biscuit, and canned peaches in light syrup. Bacon and canned peaches in syrup are not recommended for cancer prevention due to their high content of saturated fats and added sugars, respectively.
C. Oatmeal with raisins and nuts, with skim milk and 1/2 grapefruit. This meal contains whole grains from the oatmeal, antioxidants from the raisins and nuts, and vitamin C from the grapefruit, all of which have been associated with reducing the risk of certain cancers.
D. Pancakes with blueberries and maple syrup, and a turkey sausage patty. While blueberries are rich in antioxidants, the pancakes and maple syrup contribute refined carbohydrates and added sugars, which are not recommended for cancer prevention.

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A client is receiving total parenteral nutrition (TPN) via a subclavian central line, and the solution bag is nearly empty. The next bag of TPN is not available from the pharmacy. Which action should the nurse implement until the fluid arrives?

Nursing Test Bank

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