A nurse is planning care for a client who is to start receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?
Change the TPN tubing every 48 hr
Allow 18 hr for the lipids to infuse when not mixed with the TPN solution.
Use a 1.2 micron filter when infusing TPN with fat emulsions added.
Change the TPN solution after 36 hr.
The Correct Answer is C
Rationale:
A. The tubing for TPN must be changed every 24 hr (not 48 hr) to reduce the risk of central line–associated bloodstream infection (CLABSI).
B. Lipid emulsions should not hang for more than 12 hr to prevent bacterial growth and infection.
C. A 1.2-micron filter is required for TPN that contains lipids to remove particulate matter, bacteria, and fungi, since lipid solutions cannot pass through smaller filters.
D. TPN solutions should be changed every 24 hr (not 36 hr) to reduce infection risk.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. While bleeding is a potential risk of paracentesis, it is less common than infection.
B. This is not a typical complication of paracentesis.
C. Although large-volume paracentesis can occasionally affect kidney perfusion, renal failure is not the most common complication.
D. Infection of the peritoneal cavity (spontaneous bacterial peritonitis) is the most common and serious complication associated with paracentesis. Proper aseptic technique is essential to minimize this risk.
Correct Answer is ["A","B","C"]
Explanation
Rationale:
A. Decompensated cirrhosis impairs the liver’s ability to process bilirubin, leading to yellowing of the skin and eyes.
B. Accumulation of ammonia and other toxins due to liver dysfunction can cause confusion, altered level of consciousness, and asterixis.
C. Fluid shifts into the peritoneal cavity occur due to low albumin levels and portal hypertension, causing abdominal distention.
D. While beneficial for overall health, exercise is not a clinical manifestation of cirrhosis.
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