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
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
No explanation
Correct Answer is B
Explanation
A) Referring the family to a chronic pain support group could be beneficial, but it should not be the first action taken. Understanding the child’s specific situation and triggers is more immediate.
B) Reviewing the child's electronic pain diary is the most appropriate first action. This diary can provide valuable insights into the frequency, duration, and intensity of the migraine headaches, as well as potential triggers. Understanding these details is essential for guiding further interventions and discussions with the healthcare provider.
C) Requesting a change in medication from the provider may be necessary if the child’s current treatment is ineffective, but this decision should be based on comprehensive assessment data. Without first reviewing the pain diary, the nurse may not have enough information to support a medication change.
D) Setting up an appointment with the school nurse could be useful for monitoring the child during school hours, but again, it should not take precedence over gathering more information about the migraines first. Understanding the child’s migraine patterns and triggers is essential before considering additional support.
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