A nurse is caring for a client who is mechanically ventilated and receiving propofol intravenously. Which of the following manifestations should the nurse identify as a complication of administration?

Hypokalemia

Sepsis

Urinary retention

Hypoglycemia

Answer and Explanation

The Correct Answer is B

B) Sepsis: Propofol is an intravenous sedative-hypnotic agent commonly used for sedation in mechanically ventilated patients. While propofol itself does not directly cause sepsis, its use can increase the risk of sepsis-related complications, such as infection. Propofol is typically administered intravenously, and improper handling or contamination of equipment, including intravenous lines and medication vials, can introduce pathogens into the bloodstream, leading to bloodstream infections (sepsis). Additionally, prolonged use of propofol may suppress immune function, further increasing the susceptibility to infection. Therefore, the nurse should monitor the client for signs and symptoms of sepsis, such as fever, chills, hypotension, tachycardia, and altered mental status, as a potential complication of propofol administration.

A) Hypokalemia: Hypokalemia, or low potassium levels, is not a common complication directly associated with propofol administration. While electrolyte imbalances may occur in critically ill patients, especially those receiving mechanical ventilation, hypokalemia is more likely to result from other factors such as diuretic therapy, gastrointestinal losses, or inadequate potassium intake.

C) Urinary retention: Urinary retention is not a typical complication of propofol administration. While sedative medications like propofol can affect bladder function, causing urinary retention in some cases, it is not a commonly reported complication of propofol use in mechanically ventilated patients.

D) Hypoglycemia: Hypoglycemia, or low blood sugar levels, is a potential complication of propofol administration, particularly in critically ill patients who may have altered glucose metabolism. However, hypoglycemia is not as commonly associated with propofol use as sepsis-related complications. Close monitoring of blood glucose levels is essential when administering propofol, especially if the client has preexisting diabetes mellitus or other risk factors for hypoglycemia. However, sepsis is a more direct and significant complication associated with propofol administration in mechanically ventilated patients.

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Correct Answer is C

Explanation

A) Change the solution every 36 hr: Total parenteral nutrition (TPN) solutions are typically changed every 24 hours to reduce the risk of contamination and infection. Changing the solution every 36 hours does not adhere to the standard practice for TPN administration and may increase the client's risk of complications.

B) Obtain the client's weight three times a week: Monitoring the client's weight is important for assessing nutritional status and adjusting the TPN prescription as needed. However, the frequency of weight measurements may vary depending on the client's condition and the healthcare provider's orders. Three times a week is a common schedule for weight monitoring in clients receiving TPN, but it should be determined based on individual client needs and provider orders.

C) Keep the solution refrigerated until 1 hr before infusion: This is the correct action. TPN solutions are typically stored in the refrigerator to maintain stability and prevent microbial growth. However, they should be removed from the refrigerator and allowed to warm to room temperature for about 1 hour before infusion to prevent discomfort and reduce the risk of metabolic complications when administered to the client.

D) Check the client's WBC count daily: While monitoring the client's white blood cell (WBC) count is important for assessing for infection and other complications, checking it daily may not be necessary for all clients receiving TPN. The frequency of WBC count monitoring should be based on the client's condition, overall clinical status, and healthcare provider's orders.

A. Urinary output B. Blood glucose level C. Weight D. Heart rate

Correct Answer is A

Explanation

A) Urinary output: Confusion and pitting edema can be signs of fluid overload, a potential complication of TPN administration. Assessing urinary output can help determine if the client is experiencing fluid overload by evaluating the kidneys' ability to excrete excess fluid. Decreased urinary output may indicate renal impairment or inadequate fluid elimination, which can exacerbate fluid overload and contribute to symptoms such as confusion and edema.

B) Blood glucose level: Monitoring blood glucose levels is important in clients receiving TPN, especially if they have diabetes or are at risk of hyperglycemia due to TPN's high glucose content. However, in this scenario, the client's symptoms of confusion and pitting edema suggest a more immediate concern related to fluid status rather than glucose regulation.

C) Weight: Monitoring weight is essential in assessing fluid balance and detecting changes in hydration status. However, assessing weight may not provide immediate information on the client's current fluid overload status. While weight changes over time can indicate fluid retention or loss, assessing urinary output is more direct in evaluating the client's response to slowing the TPN infusion rate.

D) Heart rate: Changes in heart rate can occur in response to fluid volume overload or dehydration. However, assessing heart rate may not provide immediate information on the client's current fluid status. Monitoring heart rate is important in assessing cardiovascular function but may not be the most relevant assessment immediately after slowing the TPN infusion rate in a client with signs of fluid overload

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A nurse is caring for a client who is mechanically ventilated and receiving propofol intravenously. Which of the following manifestations should the nurse identify as a complication of administration?

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