A nurse is providing teaching to the parent of a toddler about appropriate snacks. Which of the following foods should the nurse include?

Choice A reason: 0.9% sodium chloride, also known as normal saline, is not the best choice for interim fluid replacement when TPN is delayed. While it can maintain hydration and electrolyte balance, it does not provide the necessary calories that TPN supplies. TPN solutions are rich in dextrose, amino acids, and lipids, which are essential for patients who cannot receive nutrition through their gastrointestinal tract.

Choice B reason: Dextrose 5% in water (D5W) provides some calories but not enough to meet the nutritional needs of a patient who is dependent on TPN. D5W contains 5 grams of dextrose per 100 mL, providing 170 calories per liter. This is insufficient for patients who require high-calorie intake due to their inability to eat or absorb nutrients normally.

Choice C reason: Dextrose 10% in water (D10W) is the most appropriate choice for interim fluid replacement when TPN is delayed. D10W provides 10 grams of dextrose per 100 mL, offering 340 calories per liter. This higher concentration of dextrose helps to maintain the patient’s caloric intake and prevent hypoglycemia until the next TPN container is available.

Choice D reason: Lactated Ringer’s solution is primarily used for fluid and electrolyte replacement. It contains sodium, potassium, calcium, chloride, and lactate, but it does not provide the necessary calories that TPN supplies. Therefore, it is not suitable for maintaining the nutritional needs of a patient who is dependent on TPN.

Choice A reason: Transporting a school-age client who is in traction to another department is unsafe for a volunteer. Traction involves the use of weights and pulleys to align or immobilize a part of the body, typically after a fracture. This requires careful handling and monitoring to ensure the traction remains effective and does not cause additional injury. Only trained healthcare professionals should manage and transport clients in traction to prevent complications.

Choice B reason: Reading a book to a preschool client who has AIDS is a safe and appropriate assignment for a volunteer. AIDS (Acquired Immunodeficiency Syndrome) is not transmitted through casual contact such as reading a book together. Volunteers can provide emotional support and companionship to children with AIDS without risk of transmission.

Choice C reason: Playing a computer video game with an adolescent who has sickle cell disease is also a safe and suitable activity for a volunteer. Sickle cell disease is a genetic disorder that affects the shape of red blood cells, leading to various complications. However, it is not contagious, and engaging in recreational activities can help improve the adolescent’s quality of life and provide a sense of normalcy.

Choice D reason: Rocking an infant who was admitted for croup is a safe task for a volunteer. Croup is a respiratory condition characterized by a barking cough, often caused by a viral infection. While it can be contagious, the risk of transmission can be minimized with proper hygiene practices. Volunteers can provide comfort and soothing to infants with croup under the supervision of healthcare staff.