A nurse is providing discharge teaching to a client who will receive total parenteral nutrition (TPN) at home. Which of the following information should the nurse include?

Instruct the client that their central line dressing must be changed every 24 hr.

Instruct the client to weigh themselves daily and record their weight.

Instruct the client that one container of TPN may infuse for up to 72 hr.

Instruct the client to speed up the rate of their TPN infusion if it falls behind schedule.

Answer and Explanation

The Correct Answer is B

A) Instruct the ’lient that their central line dressing must be changed every 24 hr: While it's essential to maintain proper hygiene a’d care for a central line to prevent infection, changing the dressing every 24 hours may not be necessary. The frequency of dressing changes depends on institutional policies and the client's condition. Providing accurate informat’on about dressing changes based on specific guidelines is important for the client's safety and the prevention of central l’ne-related infections.

B) Instruct the client to weigh themselves daily and record their weight: This is the correct instruction. Monitoring daily weight allows for the assessment of fluid status and the effectiveness of TPN therapy. Weight gain or loss can indicate fluid retention or depletion, respectively, which may necessitate adjustments to the TPN prescription. Recording daily weights provides valuable data for healthcare providers to evaluate the client's response to TPN and make appropriate m’difications to the treatment plan.

C) Instruct the client that one container of TPN may infuse for up to 72 hr: The duration of TPN administration varies depending on factors such as the client's nutritional needs, medical condition, ’nd the stability of the TPN solution. While some TPN solutions may be stable for up to 24-48 hours, infusing for 72 hours could increase the risk of contamination and compromise the integrity of the solution, leading to adverse effects. Providing accurate information about the duration of TPN infusion based on the specific prescription ensures the client's safety and the efficacy of therapy.

D’ Instruct the client to speed up the rate of their TPN infusion if it falls behind schedule: Altering the rate of TPN infusion without healthcare provider guidance can lead to complications such as hyperglycemia, electrolyte imbalances, or fluid overload. TPN infusion rates are carefully prescribed based on the client's nutritional needs and metabolic status’ If the infusion falls behind schedule, it's essential for the client to contact th’ir healthcare provider for guidance on adjusting the infusion rate or managing any potential issues.

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Correct Answer is A

Explanation

A) Hypertension: Phenelzine is a monoamine oxidase inhibitor (MAOI) used as an antidepressant medication. It works by inhibiting the breakdown of neurotransmitters such as serotonin, norepinephrine, and dopamine in the brain. When phenelzine is taken with foods high in tyramine, such as aged cheese, a potentially dangerous interaction can occur. Tyramine-rich foods can cause the release of stored catecholamines, leading to a sudden increase in blood pressure, known as a hypertensive crisis. Symptoms of a hypertensive crisis can include severe headache, palpitations, chest pain, nausea, vomiting, and sweating. Therefore, hypertension is a manifestation of the interaction between phenelzine and aged cheese.

B) Bradycardia: Bradycardia, or slow heart rate, is not typically associated with the interaction between phenelzine and aged cheese. Instead, the interaction is more commonly associated with a sudden increase in blood pressure (hypertension).

C) Somnolence: Somnolence, or drowsiness, is a common side effect of phenelzine but is not specifically related to the interaction between phenelzine and aged cheese.

D) Diarrhea: Diarrhea is not typically associated with the interaction between phenelzine and aged cheese. Instead, the interaction is more commonly associated with a sudden increase in blood pressure (hypertension).

A. Notify the nurse manager about the incident. B. Prepare and file an incident report. C. Notify the provider of the medication administration. D. Examine the client's vital signs and condition.

Correct Answer is D

Explanation

A) Notify the nurse manager about the incident: While it's important to report medication errors,’the immediate concern should be the client's well-being. Notifying the nurse manage’ can be done after addressing the client's condition.

B) Prepare and file an inc’dent report: Filing an incident report is necessary to document the error, but it should not be the first action taken. Ensuring the client's safety and well-being is the priority.’
C) Notify the provider of the medication administration: While it's important for the provider to be infor’ed of medication errors, the immediate concern should be assessing the client's response to the medication.

D) Examin’ the client's vital signs and condition: This is the’correct answer. The nurse's first action should be to assess the client's vital signs and condition to determine’any adverse effects of the medication. Digoxin is a medication used to treat heart conditions, but it can cause harm if administered when the heart rate is already low. Monitoring the client closely for signs of bradycardia or other adverse effects is essential.

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A nurse is providing discharge teaching to a client who will receive total parenteral nutrition (TPN) at home. Which of the following information should the nurse include?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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