A nurse is caring for a client who has a new prescription for total parenteral nutrition with fat emulsion. Which of the following findings should the nurse report to the provider?

Rationale:

A. Nitroglycerin transdermal patch: This prescription is incomplete because it lacks a dosage strength, application site, frequency, and duration. Without these details, safe administration cannot be ensured.

B. Aspirin 1 tablet daily: The prescription is incomplete as it does not specify the tablet’s strength (e.g., 81 mg or 325 mg). "1 tablet" is ambiguous and can vary based on available formulations.

C. Metoprolol 5 mg IV now: This is a complete prescription it includes the medication name, dose (5 mg), route (IV), and timing ("now"). It gives the nurse all essential information to safely administer the drug.

D. Furosemide 20 mg BID: While the medication, dosage, and frequency are provided, the route is missing. Furosemide can be given orally or intravenously, so this omission makes the prescription incomplete.

Rationale:

• Insert a nasogastric tube and maintain low intermittent suction: This is anticipated to help decompress the stomach, reduce nausea and vomiting, and prevent aspiration in a client with severe pancreatitis who is vomiting and has abdominal distension.
• Administer IV lactated Ringer's: IV fluids are critical for hydration and to correct electrolyte imbalances in acute pancreatitis. Lactated Ringer’s is preferred over normal saline because it better maintains acid-base balance.
• Insert an indwelling urinary catheter: This is generally contraindicated unless necessary, as it increases the risk of infection. No information indicates urinary retention or need for strict output monitoring that outweighs infection risks.
• Administer IV famotidine: Famotidine reduces gastric acid secretion, which helps protect the gastric mucosa and may be beneficial in preventing stress ulcers in critically ill clients. It is appropriate in this situation.