A nurse is caring for a client who has Crohn's disease and is receiving parenteral nutrition. Which of the following interventions should the nurse include in the care of this client?

Remove unused parenteral nutrition after 12 hr of use.

Monitor the flow rate of the parenteral nutrition carefully and increase the rate as needed if it falls behind.

Remove the parenteral nutrition solution from the refrigerator 2 hr before infusion.

Monitor daily laboratory values and report as needed.

Answer and Explanation

The Correct Answer is D

A. Parenteral nutrition (PN) should not be left out for extended periods. Generally, unused PN should be discarded after 24 hours, not 12 hours, to prevent contamination and bacterial growth.
B. The flow rate of PN should be monitored and adjusted carefully, but it should not be increased without orders. Rapid adjustments could cause complications such as fluid overload or electrolyte imbalances.
C. PN solution should be removed from the refrigerator 1 to 2 hours before use to allow it to come to room temperature, but 2 hours may be too long. It should be done cautiously to avoid bacterial growth at room temperature.
D. Monitoring daily laboratory values is essential for assessing the client's nutritional status, electrolytes, liver function, and kidney function. These values help guide ongoing care and detect complications of PN, such as electrolyte imbalances or liver dysfunction.

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Correct Answer is C

Explanation

A. Encouraging coughing and deep breathing is important for promoting the clearance of respiratory secretions. However, while it aids in mobilizing secretions, it does not directly thin the mucus.
B. Frequent ambulation helps to improve overall lung function and prevent complications like pneumonia, but it does not specifically thin respiratory secretions.
C. Increasing fluid intake helps thin the respiratory secretions by providing hydration, making it easier for the body to expel mucus through coughing. Hydration is critical for reducing the viscosity of sputum, thus promoting its removal.
D. Regular use of the incentive spirometer helps prevent atelectasis and improve lung expansion but does not directly affect the thinning of respiratory secretions.

A. "You can expect fecal output within 24 hours." B. "You may experience a small amount of bleeding around the stoma." C. "You will need to increase your dietary intake of raw vegetables." D. "You can expect the stoma to be purplish in color for the first week."

Correct Answer is B

Explanation

A. Fecal output from a new colostomy typically begins within 2 to 4 days, not within 24 hours. This is due to the time needed for bowel function to resume after surgery.
B. A small amount of bleeding around the stoma can occur as part of normal healing, especially in the first few days after surgery. It should not be excessive or prolonged.
C. Raw vegetables and high-fiber foods should be avoided immediately after surgery as they can irritate the digestive tract and cause blockages in the stoma. A low-fiber diet is recommended initially.
D. The stoma should initially be red or pink in color, not purplish. A purplish color could indicate impaired circulation, which would require medical attention.

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A nurse is caring for a client who has Crohn's disease and is receiving parenteral nutrition. Which of the following interventions should the nurse include in the care of this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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