A nurse is caring for a client who has a prescription for total parental nutrition (TPN).
Which of the following routes of administration should the nurse use?
Midline catheter.
Central venous access device.
Subcutaneous.
Intraosseous.
The Correct Answer is B
This is because TPN solutions are concentrated and can cause thrombosis of peripheral veins, so a central venous catheter is usually required. TPN should only be used when the intestine is unavailable or unable to absorb nutrients.
Choice A is wrong because a midline catheter is a type of peripheral catheter that can only be used for solutions with low or moderate osmolarity, not for TPN.
Choice C is wrong because subcutaneous administration is not a route for delivering TPN, which requires intravenous infusion.
Choice D is wrong because intraosseous administration is an emergency route for delivering fluids and drugs when intravenous access is not available, not for TPN.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Pioglitazone is a medication that belongs to a class of drugs called thiazolidinediones, which are used to treat type 2 diabetes by improving insulin sensitivity. One of the common side effects of pioglitazone is edema, which is swelling caused by excess fluid in the body tissues. This can lead to fluid retention and weight gain and may worsen heart failure in some patients.
Choice A is wrong because tinnitus, which is ringing or buzzing in the ears, is not a known side effect of pioglitazone.
Choice B is wrong because insomnia, which is difficulty falling or staying asleep, is not a known side effect of pioglitazone.
Choice C is wrong because orthostatic hypotension, which is a drop in blood pressure when standing up from a sitting or lying position, is not a known side effect of pioglitazone.
In fact, pioglitazone may cause low blood sugar (hypoglycemia) when used with other diabetes medications, which can cause symptoms such as dizziness, sweating, and confusion.
Correct Answer is A
Explanation
The correct sequence for mixing regular insulin and NPH insulin in the same syringe is important to ensure proper dosing. The nurse should follow these steps:
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Inject air into the NPH (intermediate-acting) insulin vial: Injecting air into the NPH vial first helps to equalize the pressure in the vial, making it easier to withdraw the insulin later. This step is done first to avoid contaminating the regular insulin vial with NPH insulin.
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Inject air into the regular insulin vial: Next, inject an amount of air equal to the intended regular insulin dose into the regular insulin vial.This also helps to equalize the pressure and makes it easier to withdraw the insulin.
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Withdraw the regular insulin from the vial: The nurse should withdraw the regular insulin first because it is clear and not contaminated. This prevents any NPH insulin from mixing into the regular insulin vial.
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Withdraw the regular insulin from the vial: Finally, the nurse withdraws the NPH insulin. Since the regular insulin has already been drawn up, there is no risk of contaminating the regular insulin with NPH insulin.
This sequence ensures that you don't contaminate the vials, and you accurately withdraw the appropriate doses of each insulin type.
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