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A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The nurse notices that the solution bag is almost empty and there is not another bag of TPN to administer. Which of the following IV solutions should the nurse administer until the next bag of TPN solution is available?

A.

59% dextrose in lactated Ringer's solution (DLR)

B.

0.45% sodium chloride (0.45% NaCl)

C.

10% dextrose in water (DW)

D.

Lactated Ringer's solution

Answer and Explanation

The Correct Answer is C

Rationale:
A. 59% dextrose in lactated Ringer’s is not a standard solution and would be hypertonic and unsafe.
B. 0.45% sodium chloride does not provide the glucose necessary to prevent hypoglycemia.
C. 10% dextrose in water (D10W) is correct. If TPN runs out, a dextrose-containing solution should be administered to prevent hypoglycemia until the next TPN bag is available.
D. Lactated Ringer’s does not provide sufficient glucose to maintain blood sugar during TPN interruption.


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Related Questions

Correct Answer is B

Explanation

Rationale:
A. Clients with hepatitis often experience anorexia and nausea. Small, frequent meals are better tolerated than three large meals.
B. Carbohydrates are the primary source of calories in clients with hepatitis. They help spare protein and allow the liver to rest and heal. This is the recommended dietary intervention.
C. Protein should be limited in clients with severe hepatitis, especially if liver function is impaired, because excess protein can worsen encephalopathy.
D. Acetaminophen is hepatotoxic and should be avoided in clients with hepatitis due to the risk of further liver damage.

Correct Answer is []

Explanation

Rationale:

  • Potential Condition: The client with cirrhosis shows elevated ammonia (236 mcg/dL), confusion, agitation, and disorientation, which are classic findings of hepatic encephalopathy.
  • Actions to Take:
    • Lactulose is given to lower ammonia levels by promoting its excretion through the stool.
    • Assessing for asterixis (flapping tremor of the hands) is key in identifying worsening encephalopathy.
  • Parameters to Monitor:
    • Neurologic status (orientation, cognition, responsiveness) should be monitored closely to evaluate improvement or deterioration.
    • Safety measures are essential because confusion and agitation increase the client’s risk for falls and injury.

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