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.
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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Related Questions
Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}
Explanation
Rationale:
Hypoxia: The client's decreased oxygen saturation (SaO2) despite oxygen therapy and the presence of respiratory distress (tachypnea, shortness of breath) indicate hypoxia.
Pneumonia: The client's fever, increased respiratory rate, decreased oxygen saturation, and crackles in the lungs are indicative of pneumonia, particularly in the right lower lobe as evidenced by the chest X-ray.
Correct Answer is B
Explanation
A. "Moon phase" is not a correct term related to prednisone use. The term "moon face" refers to the round, puffy face that can result from prolonged steroid use, which is a side effect, but it is not something the patient needs to notify the healthcare provider about unless it is accompanied by other severe symptoms.
B. Taking the steroid medication as prescribed is essential. Prednisone is a corticosteroid, and missing doses or abruptly stopping the medication can lead to complications such as adrenal insufficiency. It's important for the client to adhere to the prescribed regimen to manage inflammation and minimize the risk of side effects.
C. Steroids like prednisone can cause increased blood glucose levels, so it's important for the client to monitor blood glucose more frequently. If blood glucose levels exceed 150 mg/dL, they should notify their healthcare provider, but this is not the immediate management strategy for this scenario.
D. Prednisone should be taken with food to reduce gastrointestinal irritation, not on an empty stomach. Taking it without food can increase the risk of stomach upset and ulcers, particularly in patients with inflammatory bowel disease.
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