A nurse is assessing a client who has received treatment for hypernatremia. Which of the following findings indicates the treatment has been effective?

Choice A reason: Flossing dentures is not necessary, as dentures do not have spaces between the teeth where plaque and food particles can accumulate. Flossing dentures may damage the denture material or cause it to loosen.

Choice B reason: Dentures should be cleaned with a soft material to prevent scratches or damage. A washcloth is gentle enough to clean the denture surfaces without causing harm.

Choice C reason: Wiping dentures before storing them in a dry container at night is not advisable, as it may cause the dentures to crack or warp. Dentures should be soaked in water or a denture cleanser solution overnight to keep them moist and prevent them from losing their shape.

Choice D reason: Wrapping gloved fingers with gauze to remove dentures is not a standard practice. Dentures should be removed carefully by rocking them slightly to break the seal with the gums. Using gauze is unnecessary and may not be as effective or safe for the dentures or the oral tissues.

Choice A reason: Dyspnea is a sign of pulmonary edema, which can occur as a complication of parenteral nutrition due to fluid overload or allergic reaction¹². The nurse should monitor the client's respiratory status and oxygen saturation and report any signs of respiratory distress.

Choice B reason: Parenteral nutrition should not be infused by gravity, as this can cause fluctuations in the infusion rate and lead to hyperglycemia or hypoglycemia¹³. The nurse should use an infusion pump to deliver parenteral nutrition at a constant and controlled rate.

Choice C reason: Parenteral nutrition solution should be administered within 30 min after removing from the refrigerator, as prolonged exposure to room temperature can increase the risk of bacterial contamination and infection¹⁴. The nurse should check the expiration date and inspect the solution for any discoloration, cloudiness, or particulate matter before administration.

Choice D reason: Parenteral nutrition bag and infusion tubing should be changed every 24 hr, not every 72 hr, to prevent the growth of microorganisms and reduce the risk of infection¹⁵. The nurse should use aseptic technique when changing the bag and tubing and follow the facility's protocol for dressing changes and catheter care.

Choice E reason: Parenteral nutrition should be started only after the central venous catheter position is confirmed by radiology, as incorrect placement can cause serious complications such as pneumothorax, hemothorax, or cardiac tamponade¹⁶. The nurse should obtain a chest x-ray and wait for the provider's confirmation before initiating parenteral nutrition.