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?
59% dextrose in lactated Ringer's solution (DLR)
0.45% sodium chloride (0.45% NaCl)
10% dextrose in water (DW)
Lactated Ringer's solution
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Obtaining a dietary history is important but not the priority in an acute exacerbation.
B. Reviewing electrolyte values is the first action. Clients with acute ulcerative colitis are at risk for fluid and electrolyte imbalances due to diarrhea, making this a priority assessment to prevent complications.
C. Investigating emotional concerns is important for holistic care but is secondary to addressing physiologic needs.
D. Checking perianal skin integrity is necessary but comes after assessing critical physiologic risks like electrolyte imbalances.
Correct Answer is C
Explanation
Rationale:
A. Pain assessment is important but not the immediate priority following an EGD. Discomfort is expected after the procedure, yet it does not pose the greatest risk to airway safety.
B. Nausea should be monitored, especially since sedation and irritation of the upper GI tract can cause vomiting, but this is not the most critical concern immediately after the procedure.
C. The gag reflex must be assessed first because topical anesthetics used during the EGD suppress the swallowing and protective airway reflexes. If oral fluids or food are given before the gag reflex returns, the client is at high risk for aspiration, which can lead to pneumonia or airway obstruction. Ensuring the gag reflex has returned is the priority safety measure before advancing the diet or giving oral medications.
D. Level of consciousness should also be assessed, since sedatives are commonly used during the procedure. However, the risk of aspiration from an absent gag reflex presents a more immediate threat to life and therefore takes priority.
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