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 A
Explanation
A. Brushing the client's teeth with a suction toothbrush every 12 hours is a key intervention to reduce the risk of ventilator-associated pneumonia (VAP). Oral hygiene helps to decrease the accumulation of bacteria in the mouth, which could potentially be aspirated into the lungs and cause infection. This should be done more frequently, often every 4–6 hours, to reduce bacterial colonization.
B. Providing humidity to the ventilator tubing is necessary to maintain adequate moisture and prevent airway dryness, but it does not directly reduce the risk of VAP. Oral care and head-of-bed positioning are more crucial in preventing infection.
C. The head of the client's bed should be kept elevated, not flat, to reduce the risk of aspiration, which can lead to VAP. Keeping the head of the bed at a 30–45 degree angle is recommended.
D. Turning the client every 4 hours is important for preventing pressure ulcers and promoting circulation but is not the most effective intervention for reducing the risk of VAP. Frequent oral care and appropriate positioning are more important.
Correct Answer is C
Explanation
A. Total loss of gastric enzymes is not a primary cause of dumping syndrome. While gastric enzymes may be reduced following gastric surgery, the syndrome is primarily related to the way food moves through the digestive tract.
B. Excess secretion of digestive enzymes in the intestines does not directly cause dumping syndrome. Although enzyme levels can be affected by surgery, dumping syndrome is more about the timing and volume of food delivery to the intestines.
C. Rapid emptying of stomach contents into the small intestine is the primary cause of dumping syndrome. This occurs because the normal regulatory mechanisms of the stomach are bypassed or disrupted after gastric resection, leading to a quick shift of food into the small intestine, which causes symptoms like nausea, diarrhea, and dizziness.
D. Excess glycogen production by the liver is not related to dumping syndrome. This would be more relevant to conditions affecting glucose metabolism, not gastrointestinal emptying.
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