A nurse is admitting a client who reports anorexia and is experiencing malnutrition. Which of the following laboratory findings should the nurse expect to be altered?

a. Hypertension and crackles:

While hypertension can be associated with various conditions, such as cardiovascular diseases or stress, it is not directly related to the cessation of TPN infusion.

Crackles in the lungs are often indicative of fluid accumulation or inflammation, commonly seen in conditions like pneumonia or heart failure. They are not typically associated with the interruption of TPN infusion.

b. Fever and chills:

Fever and chills can be symptoms of infection or inflammatory processes in the body. However, they are not specifically related to the interruption of TPN infusion.

In the context of TPN cessation, the focus would be on metabolic changes rather than infectious processes.

c. Excessive thirst and urination:

Excessive thirst and urination are classic symptoms of hyperglycemia, which can occur when TPN, particularly if it contains a high glucose concentration, is abruptly interrupted.

When TPN infusion stops, there is no longer a continuous supply of glucose to the body, leading to increased blood glucose levels and subsequent polyuria (excessive urination) and polydipsia (excessive thirst) as the body tries to eliminate excess glucose.

d. Shakiness and diaphoresis:

Shakiness and diaphoresis (excessive sweating) are classic symptoms of hypoglycemia, which can occur if TPN, particularly if it contains a high concentration of insulin, is abruptly interrupted.

TPN solutions often contain glucose and insulin to maintain proper blood glucose levels. If the infusion is stopped suddenly, there may be a rapid decline in blood glucose levels, leading to hypoglycemia, which manifests as shakiness, diaphoresis, confusion, and other neuroglycopenic symptoms.

- A) Elevating the bed to a comfortable position for the nurse is important to prevent strain or injury to the nurse's back. However, this action alone does not ensure the client's safety during the transfer.
- B) While acquiring help can be useful, especially for a heavy client or one with limited mobility, it is not the primary action to ensure safety during the transfer.
- C) Placing the wheelchair at a 90° angle to the bed may make the transfer more difficult because it does not allow for the most direct path to the wheelchair.
- D) Locking the wheels of both the bed and the wheelchair is the correct action to take to ensure stability and prevent movement, providing a safe transfer for the client.