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?
Change the PN infusion bag every 48 hr.
Prepare the client for a central venous line.
Obtain random blood glucose daily.
Administer the PN and fat emulsion separately.
The Correct Answer is B
Prepare the client for a central venous line.
Parenteral nutrition (PN) with 20% dextrose and fat emulsions is a hypertonic solution that requires infusion through a central venous line to prevent damage to peripheral veins.
Choice A is wrong because the PN infusion bag should be changed every 24 hours, not every 48 hours.
Choice C is wrong because blood glucose should be monitored more frequently than once daily when initiating PN therapy.
Choice D is wrong because PN and fat emulsions can be administered together in a total nutrient admixture (TNA)1.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
The correct answers are:
- c."I need to have a fire escape plan with my family."
- d."I will use the grab bars when getting in and out of the bathtub."
Rationale for each choice:
Choice c:
Having a fire escape plan is crucial for home safety. It ensures that all family members know what to do in the event of a fire, which can save valuable time and lives. Here's a detailed explanation of why a fire escape plan is essential:
- Early Escape:A plan promotes quick evacuation,as everyone understands the escape routes and procedures.
- Reduced Panic:Knowing what to do in a crisis minimizes panic and confusion,allowing for calmer and more efficient actions.
- Accountability:The plan ensures that no one is left behind,especially children,older adults,or individuals with disabilities.
- Firefighter Assistance:It provides vital information to firefighters,aiding their rescue efforts.
- Regular Practice:Regularly practicing the plan familiarizes everyone with their roles and actions,ensuring smoother execution in a real fire.
Choice d:
Grab bars provide stability and support, reducing the risk of falls in bathrooms. Falls are a major safety hazard, especially for older adults, and can lead to serious injuries. Grab bars offer several benefits, including:
- Entering and Exiting:They facilitate safe entry and exit from the bathtub or shower,especially on slippery surfaces.
- Balance Support:They provide support when standing,reducing the likelihood of losing balance.
- Transfer Assistance:They assist individuals with mobility impairments in safely transferring between the bathtub,shower,or toilet.
- Confidence Boost:They offer a sense of security,allowing individuals to feel more confident and independent in the bathroom.
Rationale for incorrect choices:
Choice a:
Setting a hot water heater to 140 degrees Fahrenheit is unsafe. It can cause scalding burns within seconds, especially for children and older adults. The recommended temperature is 120 degrees Fahrenheit to balance safety and energy efficiency.
Choice b:
Taping over frayed electrical cords is a temporary and hazardous fix. It does not address the underlying issue of damaged wiring, which can lead to electrical shocks, fires, or electrocution. Frayed cords should be replaced immediately with new, undamaged ones.
Correct Answer is A
Explanation
Gastric residual of 300 mL at the end of the shift is an unexpected finding.
Gastric residual volume refers to the volume of fluid remaining in the stomach during enteral feeding.
A gastric residual volume of less than or equal to 500 mL every 6 hours is considered safe and indicates that the gastrointestinal tract is functioning.
Choice B is wrong because weight gain is expected during enteral feeding.
Choice C is wrong because a blood glucose level of 110 mg/dL is within the normal range.
Choice D is wrong because diarrhea can be a common side effect of enteral feeding.
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