A nurse is planning to administer total parenteral nutrition (TPN) to a client who is malnourished. Which of the following actions should the nurse plan to take? (Select all that apply.)

Remove the solution from the refrigerator 1 hr before infusing.

Increase the rate of the infusion as needed to keep it on schedule.

Weigh the client every other day.

Change the client's TPN catheter tubing every 72 hr.

Infuse TPN through a central venous line.

Answer and Explanation

Correct Answer : A,E

A. Remove the solution from the refrigerator 1 hr before infusing: Allowing the TPN solution to warm to room temperature helps reduce the risk of vein irritation and discomfort. Cold solutions can cause venospasm or systemic reactions when infused into the bloodstream.
B. Increase the rate of the infusion as needed to keep it on schedule: TPN must be administered at a consistent prescribed rate. Increasing the rate without orders can lead to hyperglycemia, fluid overload, or metabolic complications. Any delays should be reported to the healthcare provider.
C. Weigh the client every other day: Daily weight monitoring is essential in TPN therapy to assess fluid balance and nutritional status. Weighing the client only every other day may delay the recognition of fluid overload or dehydration.
D. Change the client's TPN catheter tubing every 72 hr: TPN tubing should be changed every 24 hours to reduce the risk of catheter-related bloodstream infections. Extending beyond this time frame increases the likelihood of microbial contamination.
E. Infuse TPN through a central venous line: Due to its high glucose and osmolarity content, TPN must be administered via a central line to prevent phlebitis and allow for rapid, well-tolerated infusion. Peripheral administration is not suitable for long-term TPN.

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Correct Answer is A

Explanation

A. Feedings should begin within 1 hr after birth. Initiating feeding within the first hour of life supports early bonding and helps stabilize the newborn’s blood glucose. This applies to both breastfed and bottle-fed infants and is considered a key component of newborn care.
B. Feedings can be controlled by gravity. Bottle feedings should not rely solely on gravity, as this can increase the risk of overfeeding and aspiration. Instead, caregivers should hold the bottle at an angle and watch for feeding cues, allowing the infant to suck and swallow at their own pace.
C. Feedings should be on demand. While on-demand feeding is typically encouraged with breastfeeding, bottle feeding is generally guided by scheduled intervals (e.g., every 3–4 hours) early on. Over time, bottle-fed infants may show hunger cues, but structured timing helps regulate intake initially.
D. Feedings may occur in clusters. Cluster feeding is common with breastfeeding due to variable milk flow and infant comfort needs. Bottle-fed infants usually have more consistent feeding patterns and are less likely to feed in unpredictable clusters.

A. Whole-wheat pasta, green salad, and diet cola B. Broiled chicken, grilled potatoes, and lemonade C. Roast beef, brown rice, and coffee D. Grilled pork loin, steamed vegetables, and water

Correct Answer is B

Explanation

A. Whole-wheat pasta, green salad, and diet cola: While this meal is low in fat and suitable for hypertension, it lacks a clear protein source. Additionally, diet cola contains caffeine and artificial sweeteners, which some clients may choose to avoid due to personal or health preferences.
B. Broiled chicken, grilled potatoes, and lemonade: This option is appropriate for a client with hypertension and complies with Islamic dietary laws. Chicken is a halal protein, and the meal is low in sodium and saturated fat. Lemonade is a non-caffeinated beverage that aligns with religious and health considerations.
C. Roast beef, brown rice, and coffee: Roast beef is permissible if it is halal, but this cannot be assumed unless specified. Coffee contains caffeine, which some individuals with hypertension may need to limit. The meal also lacks details on fat and sodium content.
D. Grilled pork loin, steamed vegetables, and water: Pork is strictly prohibited (haram) in Islamic dietary laws. Although the vegetables and water are appropriate, the inclusion of pork makes this meal unacceptable for a practicing Muslim.

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A nurse is planning to administer total parenteral nutrition (TPN) to a client who is malnourished. Which of the following actions should the nurse plan to take? (Select all that apply.)

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