A nurse is assessing a male client who began receiving total parenteral nutrition 24 hr ago. Which of the following findings should indicate to the nurse the client is experiencing a complication?

Elevated erythrocyte sedimentation rate (ESR)

Increased bilirubin levels

Guaiac fecal occult blood test positive

Weight gain 1.6 kg (3.5 lb)

Answer and Explanation

The Correct Answer is D

A. Elevated erythrocyte sedimentation rate (ESR): An elevated ESR is a nonspecific marker of inflammation. It can be elevated due to a variety of conditions, including infection, autoimmune disease, or chronic illness. In TPN, this finding would require further evaluation but is not a definitive or immediate indicator of a TPN-related complication.
B. Increased bilirubin levels: While increased bilirubin levels may suggest liver dysfunction, they are not uncommon in clients receiving TPN over an extended period due to hepatobiliary complications like cholestasis. However, after just 24 hours of TPN, a rise in bilirubin is unlikely to occur this quickly as a result of TPN alone.
C. Guaiac fecal occult blood test positive: A positive fecal occult blood test indicates the presence of gastrointestinal bleeding, which is not a typical complication associated with TPN initiation. While it is a concerning clinical finding, it is not directly linked to the use of TPN and may be related to other underlying gastrointestinal issues that need separate investigation.
D. Weight gain 1.6 kg (3.5 lb): A rapid weight gain of this magnitude within 24 hours of starting TPN suggests fluid overload, which is a potential complication of TPN therapy especially in clients with compromised cardiac or renal function. This finding indicates the need for immediate intervention to prevent further complications such as pulmonary edema or hypertension.

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Correct Answer is A

Explanation

A. "I will eat something when I feel hungry." Responding to true physical hunger is a principle of mindful eating, which supports weight loss by preventing overeating due to emotional or external cues. Recognizing and honoring hunger promotes better portion control and sustainable eating habits.
B. "I will peel apples before I eat them." Apple peels contain fiber, which increases satiety and supports digestive health. Removing the peel reduces fiber content, which may make the snack less filling and hinder weight management efforts.
C. "I will eliminate carbohydrates from my diet." Eliminating carbohydrates completely is not recommended for healthy weight loss. Balanced diets that include whole grains, fruits, and vegetables support long-term weight management and provide essential nutrients.
D. "I will use corn oil when frying foods." Frying foods, regardless of the type of oil, increases calorie density and may not support weight loss. Healthier cooking methods like baking, steaming, or grilling are preferred for reducing fat intake and promoting weight control.

A. Keep total fat intake at 25% of calories per day. B. Limit cholesterol intake to 500 mg per day. C. Consume 50% of daily food intake from protein. D. Restrict sodium intake to 3,000 mg per day.

Correct Answer is A

Explanation

A. Keep total fat intake at 25% of calories per day. It is recommended that total fat intake be between 20% and 35% of daily calories, with an emphasis on healthy fats such as unsaturated fats from plant sources. Keeping fat intake around 25% supports cardiovascular health and balanced nutrition.
B. Limit cholesterol intake to 500 mg per day. The current recommendation is to limit dietary cholesterol to less than 300 mg per day. Excess cholesterol intake can increase the risk of cardiovascular disease, especially in individuals with other risk factors.
C. Consume 50% of daily food intake from protein. Protein should make up 10% to 35% of total daily calories. Consuming 50% from protein is excessive and may displace other essential nutrients like carbohydrates and healthy fats.
D. Restrict sodium intake to 3,000 mg per day. Recommended sodium intake for healthy adults is less than 2,300 mg per day. Lower limits are suggested for individuals with hypertension, kidney disease, or other related conditions to help manage blood pressure and fluid balance.

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A nurse is assessing a male client who began receiving total parenteral nutrition 24 hr ago. Which of the following findings should indicate to the nurse the client is experiencing a complication?

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