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?
Schedules a bag and tubing change for 24 hr after the start of the infusion
Plans for a check of the client's fingerstick glucose level every 6 hr
Gradually increases the TPN infusion rate each hour until the prescribed rate is achieved
Uses the TPN IV tubing to administer the client's next dose of antibiotics
The Correct Answer is D
A: Changing the TPN bag and tubing every 24 hours is standard practice to prevent infection, so this action is appropriate.
B: Checking glucose levels every 6 hours is necessary because TPN can significantly affect blood glucose levels.
C: Gradually increasing the TPN rate is a standard procedure to monitor tolerance to the infusion.
D: This indicates a need for intervention. TPN lines should not be used for any other infusions to prevent contamination and interactions between the nutrition formula and medications.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","F","G","I","J"]
Explanation
Yellowing of the eyes could indicate hepatotoxicity, a serious adverse effect associated with some of the anti-tuberculosis medications, particularly rifampin.
Blurred vision could be a sign of optic neuritis, a rare but serious adverse effect associated with ethambutol.
Abdominal pain could indicate hepatitis or hepatotoxicity, which are potential adverse effects of anti-tuberculosis medications like isoniazid and rifampin.
Increased bruising could indicate thrombocytopenia, a serious adverse effect associated with some anti-tuberculosis medications, particularly rifampin.
Increased bleeding tendency could also indicate thrombocytopenia or other hematologic abnormalities.
Red/orange tint to urine could indicate rifampin-induced discoloration of bodily fluids, which is not harmful but can be alarming to patients.
Darkening of urine could also be a result of rifampin-induced discoloration. It's important to differentiate between this harmless side effect and hematuria, which could indicate a more serious issue.
Correct Answer is D
Explanation
A: Feeling light-headed upon standing is a common side effect of many psychotropic medications, indicating orthostatic hypotension but not necessarily requiring immediate provider intervention unless it persists or worsens.
B: Mumbling quietly could be related to the client’s schizophrenia rather than a direct effect of the medication.
C: Photosensitivity can be a side effect of some antipsychotic medications, but it is less concerning than neurological symptoms and usually manageable with lifestyle adjustments.
D: A shuffling gait can indicate the development of parkinsonism, a serious side effect of antipsychotic medications, which involves motor impairments mimicking symptoms of Parkinson's disease. This is significant and should be reported to the provider immediately for potential medication adjustment.
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