A nurse is providing discharge teaching to a client who will be receiving total parenteral nutrition (TPN) at home.
Which of the following instructions should the nurse include? (Select all that apply.)

Infuse 10 percent dextrose and water if the solution runs out.

Shake the TPN bag with fat emulsion if precipitate is present.

Maintain TPN infusion rate when behind schedule.

Keep the TPN refrigerated when not in use.

Answer and Explanation

Correct Answer : A,D

Choice A rationale

Infusing 10 percent dextrose and water prevents hypoglycemia if TPN is temporarily unavailable. This is a crucial step in maintaining the patient's blood sugar levels.

Choice B rationale

Shaking the TPN bag with fat emulsion can cause the emulsion to break, leading to potential complications. Fat emulsions should be mixed gently.

Choice C rationale

Maintaining the TPN infusion rate when behind schedule is incorrect as it can lead to rapid infusion and complications such as hyperglycemia and fluid overload.

Choice D rationale

Keeping the TPN refrigerated when not in use helps to maintain its stability and prevent bacterial contamination. Proper storage is essential for patient safety. .

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Correct Answer is B

Explanation

Choice A rationale

Hypokalemia involves low potassium levels and is not treated with sodium polystyrene sulfonate. This drug is used to treat elevated potassium levels.

Choice B rationale

Hyperkalemia indicates high potassium levels in the blood. Sodium polystyrene sulfonate (Kayexalate) works by exchanging sodium ions for potassium ions in the intestines, thereby lowering blood potassium levels.

Choice C rationale

Hyponatremia, or low sodium levels, is not treated with sodium polystyrene sulfonate, which targets potassium removal.

Choice D rationale

Hypocalcemia refers to low calcium levels and is unrelated to the action of sodium polystyrene sulfonate, which addresses potassium imbalance.

A. Give the insulin when the breakfast tray arrives. B. Give the insulin at 07:00. C. Give the insulin at 07:30. D. Give the insulin 30 minutes after breakfast with the client's other routine medicines.

Correct Answer is C

Explanation

Choice A rationale

Administering insulin when the breakfast tray arrives may not provide sufficient time for the insulin to take effect before the client begins eating, potentially leading to hyperglycemia.

Choice B rationale

Administering insulin at 07: is too early and may result in hypoglycemia before the client eats breakfast.

Choice C rationale

Administering insulin at 07: allows sufficient time for the insulin to take effect before the client eats breakfast, helping to maintain appropriate blood glucose levels.

Choice D rationale

Administering insulin 30 minutes after breakfast is too late and could result in hyperglycemia since the client would have already consumed carbohydrates.

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A nurse is providing discharge teaching to a client who will be receiving total parenteral nutrition (TPN) at home.Which of the following instructions should the nurse include? (Select all that apply.)

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A nurse is providing discharge teaching to a client who will be receiving total parenteral nutrition (TPN) at home.
Which of the following instructions should the nurse include? (Select all that apply.)