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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. A CBC may show leukocytosis but is not diagnostic for pancreatitis.
B. AST/ALT may be elevated if biliary obstruction is present, but they are not specific for pancreatitis.
C. Blood glucose may rise in pancreatitis due to impaired insulin release, but it is not diagnostic.
D. Amylase and lipase levels are the primary diagnostic lab tests for acute pancreatitis, with lipase being more specific and remaining elevated longer.
Correct Answer is B
Explanation
Rationale:
A. Right upper quadrant contains the liver and gallbladder; pain here is more typical of hepatobiliary disorders, not appendicitis.
B. Right lower quadrant is the correct location of McBurney’s point, found one-third of the distance from the anterior superior iliac spine to the umbilicus. Tenderness here is a classic sign of appendicitis.
C. Left lower quadrant pain is commonly associated with conditions like diverticulitis, not appendicitis.
D. Left upper quadrant contains the stomach, spleen, and pancreas tail; pain here suggests disorders of those organs, not appendicitis.
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