A nurse is caring for a client who has acute kidney injury and has been prescribed total parenteral nutrition (TPN). When educating the client on the use of TPN, which of the following information should the nurse include?
The TPN is needed to bypass your gastrointestinal tract.
The TPN will have higher levels of vitamins than the recommended daily intake.
The TPN will ensure that your glucose level stays within the expected range.
The TPN will be higher in fats and protein, but lower in carbohydrates.
The Correct Answer is A
Choice A reason: TPN is a form of nutrition that is delivered directly into the bloodstream through a central venous catheter. It is used for clients who have impaired or nonfunctional gastrointestinal tracts, such as those with acute kidney injury, bowel obstruction, or short bowel syndrome.
Choice B reason: The TPN does not necessarily have higher levels of vitamins than the recommended daily intake. The TPN is individually tailored to meet the client's nutritional needs, which may vary depending on their condition, weight, and laboratory values.
Choice C reason: The TPN does not ensure that the client's glucose level stays within the expected range. In fact, TPN can cause hyperglycemia due to the high concentration of dextrose in the solution. The client's blood glucose level should be monitored frequently and insulin should be administered as prescribed to prevent complications.
Choice D reason: The TPN is not higher in fats and protein, but lower in carbohydrates. The TPN contains a balanced mixture of macronutrients, including carbohydrates, proteins, and lipids, as well as micronutrients, such as electrolytes, vitamins, and minerals. The ratio of these components may vary depending on the client's nutritional needs and goals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Prealbumin is a protein that is synthesized by the liver and reflects the current nutritional status of the client. It has a short half-life of 2 to 3 days, which makes it a sensitive indicator of changes in protein intake. Prealbumin levels are decreased in clients who are malnourished or have inflammation, infection, or liver disease. The nurse should monitor the prealbumin levels of the client who is receiving total parenteral nutrition to ensure that they are within the normal range of 15 to 36 mg/dL.
Choice B reason: Folic acid is a water-soluble vitamin that is involved in DNA synthesis, cell division, and red blood cell production. Folic acid levels are decreased in clients who have malabsorption, alcoholism, or certain medications, such as methotrexate or phenytoin. The nurse should assess the folic acid levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.
Choice C reason: Magnesium is a mineral that is involved in many enzymatic reactions, muscle contraction, nerve transmission, and bone formation. Magnesium levels are decreased in clients who have malnutrition, diarrhea, vomiting, or diuretic use. The nurse should evaluate the magnesium levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.
Choice D reason: Transferrin is a protein that transports iron in the blood and reflects the iron stores of the client. Transferrin levels are decreased in clients who have iron deficiency anemia, chronic disease, or liver disease. The nurse should check the transferrin levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.
Correct Answer is C
Explanation
Choice C reason: This statement shows that the client has understood the importance of vitamin D and calcium for bone health. Fortified milk, fatty fish, and cheese are good sources of both nutrients, which help to maintain bone density and prevent osteoporosis.
Choice A reason: This statement is incorrect, as vitamin A supplementation can have adverse effects on bone health. Excessive intake of vitamin A can increase the risk of fractures and reduce bone mineral density.
Choice B reason: This statement is partially correct, as calcium supplementation can help to meet the daily requirement of calcium for bone health. However, calcium alone is not enough, as vitamin D is also needed to facilitate the absorption of calcium and prevent its loss from the bones.
Choice D reason: This statement is irrelevant, as none of the foods mentioned are particularly beneficial for bone health. Orange juice, lean meats, and egg whites are good sources of vitamin C, protein, and biotin, respectively, but they do not provide significant amounts of vitamin D or calcium.
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