A client was started on total parenteral nutrition (TPN) ten days ago. The nurse recognizes that the expected effect of TPN is a:

serum white blood cell count of 16,000/mm3.

pre-albumin level less than 10 mg/dl

maintenance of baseline weight or gain of up to 1 kg/day.

negative nitrogen balance.

Answer and Explanation

The Correct Answer is C

C. The expected effect of TPN is to maintain or promote weight gain in clients who are unable to meet their nutritional needs orally. TPN provides essential nutrients directly into the bloodstream, allowing for adequate caloric intake to support energy needs and promote tissue repair and growth.
A. A serum white blood cell count of 16,000/mm3 indicates leukocytosis, which may suggest infection or inflammation rather than a direct effect of TPN.
B. Pre-albumin is a marker of nutritional status, and levels below 10 mg/dl typically indicate malnutrition rather than a positive response to TPN.
D. Negative nitrogen balance occurs when the body loses more nitrogen than it gains, typically due to inadequate protein intake or increased protein breakdown. TPN provides amino acids, which are the building blocks of protein, and aims to promote a positive nitrogen balance to support tissue repair and growth.

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Correct Answer is C

Explanation

C. Medication adherence is vital for controlling inflammation and preventing flare-ups in ulcerative colitis. Therefore, ensuring that the client is taking their medications as prescribed is a primary focus of disease management, regardless of how well they have learned to manage the condition.
A. Stress can exacerbate symptoms of ulcerative colitis and may contribute to flare-ups. Therefore, understanding how the client manages stress is important. However, given that the client has lived with ulcerative colitis for close to 15 years and has learned to manage it well, this question may be less of a primary focus compared to other aspects of disease management.
B. Regular monitoring through colonoscopy is essential for detecting any changes or complications associated with ulcerative colitis, such as inflammation, dysplasia, or colon cancer.
D. While rest and adequate sleep are important for overall health and well-being, they may not be as directly related to ulcerative colitis management as medication adherence, monitoring, and stress management.

A. Notify the physician immediately. B. Notify the pharmacy when the bag is empty C. Decrease the rate to 27.1 mL/hr until the new bag is brought to the unit D. Hang a bag of D10W at the current rate until the new bag arrives

Correct Answer is C

Explanation

C. Decrease the rate to 27.1 mL/hr until the new bag is brought to the unit: This option is a suitable approach to conserve the remaining TPN solution until the new bag arrives. By halving the infusion rate, the remaining volume of TPN will last longer, ensuring the client continues to receive some nutrition and fluid support while awaiting the delivery of the new bag.
A. While it's important to inform the healthcare team about the low volume of TPN remaining, it may not require immediate physician intervention unless the situation worsens or alternative actions need to be taken.
B. Notifying the pharmacy when the bag is empty is a reasonable action, as they can prepare and deliver the next infusion bag promptly. However, it does not address the immediate need for fluid and nutrition replacement.
D. D10W (dextrose 10% in water) can help prevent hypoglycemia and provide some energy, but it does not provide the full nutritional support that TPN does. However, it can be a reasonable short- term measure while waiting for the replacement TPN bag.

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A client was started on total parenteral nutrition (TPN) ten days ago. The nurse recognizes that the expected effect of TPN is a:

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Naxlex Comprehensive Predictor Exams

The client has lived with ulcerative colitis for close to 15 years and has learned to manage it very well. At this point in time, the nurse's discussion with the client about this disease should have a primary focus on which question?

Correct Answer is C

Explanation

The nurse is caring for a client receiving a TPN Infusion running at 54.2 mL/hr and there is only 25 mL remaining in the bag. The next Infusion bag has not been brought to the unit. Which action would be appropriate?

Correct Answer is C

Explanation

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