A nurse is collecting health history data from a client who has hemorrhoids. Which of the following findings should the nurse expect?

A nurse caring for a client who is receiving total parenteral nutrition should identify that a serum calcium level of 12.5 mg/dL indicates a possible complication of this therapy. Total parenteral nutrition can result in electrolyte imbalances, including hypercalcemia (high levels of calcium in the blood).

The other laboratory results are within normal ranges and do not indicate a complication of total parenteral nutrition.

b) A BUN level of 16 mg/dL is within the normal range.

c) A serum potassium level of 4.6 mEq/L is within the normal range.

d) A WBC count of 8,000/mm³ is within the normal range.

d. Remove the IV catheter.

Explanation:

The correct answer is d. Remove the IV catheter.

If the nurse realizes that the incorrect IV solution is infusing, it is essential to take prompt action to prevent harm to the client. Removing the IV catheter is the appropriate course of action to stop the infusion of the incorrect solution.

Option a, completing an incident report, may be necessary after the immediate situation has been addressed, but it should not be the nurse's first action. The priority is to stop the incorrect solution from infusing.

Option b, allowing the current solution to finish infusing and then changing the bag, is not the correct action. Continuing the infusion of the incorrect solution can potentially harm the client and must be stopped immediately.

Option c, documenting that an error occurred in the client's medical record, is important, but it should be done after taking immediate action to stop the incorrect solution from infusing. Documentation should include the details of the incident, any actions taken, and the client's response.

By promptly removing the IV catheter, the nurse stops the infusion of the incorrect solution and prevents further harm to the client. Afterward, the nurse should assess the client for any adverse effects, inform the appropriate healthcare providers, and follow the facility's policies and procedures for reporting incidents and documenting the error.