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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
Correct Answers:
The nurse should educate the client that diagnostic imaging techniques used for assessing pancreatic ducts include Ultrasound, MRCP, and CT scan.
Rationale:
- Ultrasound is commonly used as an initial noninvasive imaging tool for detecting pancreatic abnormalities.
- MRCP (Magnetic Resonance Cholangiopancreatography) is a specialized MRI technique that provides detailed images of the pancreatic and biliary ducts.
- CT scan provides cross-sectional imaging of the pancreas and can identify masses or ductal obstruction.
- Biopsy is diagnostic but not considered an imaging technique.
- HIDA scan assesses gallbladder function, not pancreatic ducts.
- X-ray is not effective for direct pancreatic duct imaging.
Correct Answer is C
Explanation
Rationale:
A. 59% dextrose in lactated Ringer’s is not a standard solution and would be hypertonic and unsafe.
B. 0.45% sodium chloride does not provide the glucose necessary to prevent hypoglycemia.
C. 10% dextrose in water (D10W) is correct. If TPN runs out, a dextrose-containing solution should be administered to prevent hypoglycemia until the next TPN bag is available.
D. Lactated Ringer’s does not provide sufficient glucose to maintain blood sugar during TPN interruption.
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