A nurse is planning care for a client who has a new prescription for parenteral nutrition (PN) in 20% dextrose and fat emulsions. Which of the following is an appropriate action to include in the plan of care?

Administer the PN and fat emulsion separately.

Change the PN infusion bag every 48 hr.

Obtain a random blood glucose daily.

Prepare the client for a central venous line

Answer and Explanation

The Correct Answer is D

. PN with 20% dextrose requires a central venous line for administration. Peripheral veins cannot handle the high osmolarity of such solutions, which can cause phlebitis and vein damage. A central venous line is necessary to deliver the solution safely into a larger vein with a higher blood flow.
A. Fat emulsions (lipids) are often administered separately from the PN solution, but they can also be infused concurrently through a Y-connector to minimize the risk of contamination. However, it is crucial to follow the specific guidelines of the healthcare facility and the manufacturer’s recommendations. The decision to administer separately or concurrently depends on the prescribed protocol.
B. PN solutions are typically changed every 24 hours to reduce the risk of infection. The high glucose content in PN solutions provides a rich medium for bacterial growth, making it essential to adhere to strict aseptic techniques and timely changes of the infusion bag.
C. Blood glucose monitoring is crucial for clients receiving PN due to the high dextrose content, which can significantly impact blood glucose levels. However, more frequent monitoring, such as every 4-6 hours initially, is often required rather than just a random daily check. This helps in promptly identifying and managing hyperglycemia or hypoglycemia.

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Correct Answer is C

Explanation

C. Wearing a mask when working within close proximity to the client helps prevent the transmission of respiratory droplets containing the influenza virus. This is especially important when providing direct care to the client, such as during assessments or procedures.
A. Metronidazole is an antibiotic used to treat bacterial infections, not viral infections like influenza. Administering metronidazole would not prevent the spread of influenza.
B. Protective eyewear is typically used to prevent exposure to bloodborne pathogens or other bodily fluids that could splash into the eyes. In the case of influenza, the primary mode of transmission is through respiratory droplets, so protective eyewear is not necessary for preventing its spread.
D. Negative airflow rooms are typically used for clients with airborne infections, such as tuberculosis, where there is a risk of droplet nuclei remaining suspended in the air for prolonged periods. Influenza is primarily spread through respiratory droplets and does not require negative airflow isolation.

A. Eyelashes that curl slightly outward. B. Corneas with an opaque appearance C. Pupils that are 8 to 9 mm in diameter D. Eyelids that blink involuntarily 30 to 35 times per minute

Correct Answer is A

Explanation

A. Eyelashes that curl slightly outward help protect the eyes by reducing the entry of foreign particles and debris. They also help to direct tears away from the eyes and prevent excessive moisture buildup.
B. The cornea is normally transparent, allowing light to enter the eye and focusing it onto the retina. An opaque appearance of the cornea may indicate conditions such as corneal edema, scarring, or infection, which can impair vision and require further assessment and treatment.
C. The normal diameter of an adult pupil ranges from about 2 to 4 mm in bright light and up to about 4 to 8 mm in dim light. Pupils that are consistently dilated to 8 to 9 mm may indicate abnormalities such as an underlying neurological condition, drug effects, or trauma to the eye.
D. The average blink rate is around 15-20 times per minute under normal conditions.

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A nurse is planning care for a client who has a new prescription for parenteral nutrition (PN) in 20% dextrose and fat emulsions. Which of the following is an appropriate action to include in the plan of care?

Nursing Test Bank

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Correct Answer is C

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Correct Answer is A

Explanation

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