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. Vomiting is more common in small bowel obstruction and is usually less severe in large bowel obstruction.
B. A large bowel obstruction causes accumulation of gas and fecal material proximal to the blockage, leading to significant abdominal distention.
C. Large bowel obstruction may eventually cause metabolic acidosis due to impaired perfusion and tissue hypoxia, not alkalosis.
D. Back pain is not a typical sign of large bowel obstruction; the primary symptom is abdominal discomfort, distention, and constipation.
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.
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