A nurse is observing a newly licensed nurse who is administering total parenteral nutrition (TPN) to a client. Which of the following actions by the newly licensed nurse indicates a need for the nurse to intervene?

Plans for a check of the client's fingerstick glucose level every 6 hr

Schedules a bag and tubing change for 24 hr after the start of the infusion

Uses the TPN IV tubing to administer the client's next dose of antibiotics

Gradually increases the TPN infusion rate each hour until the prescribed rate is achieved

Answer and Explanation

The Correct Answer is C

A. Plans for a check of the client's fingerstick glucose level every 6 hr: Monitoring blood glucose levels is essential for clients receiving TPN due to the risk of hyperglycemia. Checking glucose every 6 hours is a standard practice that helps ensure appropriate glycemic control, so this action is appropriate.

B. Schedules a bag and tubing change for 24 hr after the start of the infusion: It is standard practice to change the TPN bag and tubing every 24 hours to reduce the risk of infection and maintain sterility. This timing aligns with best practices for TPN administration, indicating no need for intervention.

C. Uses the TPN IV tubing to administer the client's next dose of antibiotics: Using the TPN line for additional medications, such as antibiotics, can lead to complications like incompatible drug interactions or infection. TPN should ideally be delivered through a dedicated line to prevent these risks, which necessitates intervention from the supervising nurse.

D. Gradually increases the TPN infusion rate each hour until the prescribed rate is achieved: Gradual escalation of the TPN infusion rate is important to prevent complications such as hyperglycemia. This action is appropriate, as it allows the body to adapt to the increased caloric intake safely.

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Correct Answer is D

Explanation

A) "This type of seizure lasts 30 to 60 seconds.": While absence seizures typically last about 10 to 20 seconds, they can occasionally last longer, but they usually do not extend to 30 to 60 seconds. This statement may lead to misunderstanding of the duration.

B) "The child usually has an aura prior to onset.": Absence seizures generally do not have a warning or aura, which is more common in other types of seizures, such as focal seizures. Including this information could provide incorrect expectations.

C) "This type of seizure has a gradual onset.": Absence seizures have a sudden onset and are characterized by a brief loss of awareness rather than a gradual beginning. This statement does not accurately describe the nature of the seizures.

D) "This type of seizure can be mistaken for daydreaming.": This is correct. Absence seizures often result in a brief loss of consciousness that can be misinterpreted as the child simply daydreaming or zoning out, making this information essential for parents to understand.

A. Provide the client with large-handled eating utensils. B. Touch the client's arm before beginning to speak. C. Establish alternatives to verbal conversation. D. Use the numbers on a clock to describe the position of food on the client's plate.

Correct Answer is A

Explanation

A. Provide the client with large-handled eating utensils: This intervention is beneficial for clients with multiple sclerosis, as it can help improve their grip and ease the process of eating. This is particularly important for clients who may experience weakness or coordination issues.

B. Touch the client's arm before beginning to speak: While this may be a considerate gesture for individuals with hearing impairments, it is not specifically targeted to address barriers faced by clients with multiple sclerosis, who may have visual or cognitive challenges.

C. Establish alternatives to verbal conversation: While offering alternative communication methods can be helpful, the primary barriers for many clients with multiple sclerosis often relate to physical function rather than communication alone.

D. Use the numbers on a clock to describe the position of food on the client's plate: This technique can be useful for clients with visual impairments, but it does not directly address the motor and coordination challenges often faced by clients with multiple sclerosis in daily tasks like eating.

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A nurse is observing a newly licensed nurse who is administering total parenteral nutrition (TPN) to a client. Which of the following actions by the newly licensed nurse indicates a need for the nurse to intervene?

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