A nurse on a medical surgical unit is caring for a client who has a small bowel obstruction and is receiving parenteral nutrition through a central venous catheter. Which of the following actions should the nurse plan to take? (Select all that apply)
Observe for dyspnea.
Infuse parenteral nutrition by gravity.
Administer parenteral nutrition solution within 30 min after removing from the refrigerator.
Change parenteral nutrition bag and infusion tubing every 72 hr.
Begin infusion of parenteral nutrition once central venous catheter position is confirmed by radiology.
Correct Answer : A,C,E
Choice A reason: Dyspnea is a sign of pulmonary edema, which can occur as a complication of parenteral nutrition due to fluid overload or allergic reaction¹². The nurse should monitor the client's respiratory status and oxygen saturation and report any signs of respiratory distress.
Choice B reason: Parenteral nutrition should not be infused by gravity, as this can cause fluctuations in the infusion rate and lead to hyperglycemia or hypoglycemia¹³. The nurse should use an infusion pump to deliver parenteral nutrition at a constant and controlled rate.
Choice C reason: Parenteral nutrition solution should be administered within 30 min after removing from the refrigerator, as prolonged exposure to room temperature can increase the risk of bacterial contamination and infection¹⁴. The nurse should check the expiration date and inspect the solution for any discoloration, cloudiness, or particulate matter before administration.
Choice D reason: Parenteral nutrition bag and infusion tubing should be changed every 24 hr, not every 72 hr, to prevent the growth of microorganisms and reduce the risk of infection¹⁵. The nurse should use aseptic technique when changing the bag and tubing and follow the facility's protocol for dressing changes and catheter care.
Choice E reason: Parenteral nutrition should be started only after the central venous catheter position is confirmed by radiology, as incorrect placement can cause serious complications such as pneumothorax, hemothorax, or cardiac tamponade¹⁶. The nurse should obtain a chest x-ray and wait for the provider's confirmation before initiating parenteral nutrition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Vitamin D is a fat-soluble vitamin that is essential for bone health, immune function, and calcium absorption. It is mainly obtained from exposure to sunlight and animal sources, such as dairy products, eggs, and fish. Vegans are at risk for vitamin D deficiency, especially if they live in areas with limited sunlight or do not take supplements.
Choice B reason: Vitamin C is a water-soluble vitamin that is important for collagen synthesis, wound healing, and antioxidant activity. It is abundant in plant sources, such as fruits and vegetables. Vegans are not likely to be deficient in vitamin C, unless they have a very restricted diet or a malabsorption disorder.
Choice C reason: Magnesium is a mineral that is involved in many enzymatic reactions, muscle contraction, nerve transmission, and bone formation. It is widely distributed in plant and animal foods, such as nuts, seeds, legumes, grains, and green leafy vegetables. Vegans are not prone to magnesium deficiency, unless they have a chronic condition that affects magnesium absorption or excretion.
Choice D reason: Folic acid is a water-soluble vitamin that is essential for DNA synthesis, cell division, and red blood cell production. It is found in fortified grains, cereals, breads, and pasta, as well as in dark green leafy vegetables, beans, and lentils. Vegans are not at risk for folic acid deficiency, as long as they consume enough of these foods or take supplements.
Correct Answer is C
Explanation
Choice A reason: Calcium is not a dietary supplement that can help with wound healing, although it is important for bone health and muscle contraction. Calcium deficiency can cause osteoporosis, muscle cramps, and abnormal heart rhythms, but it does not affect wound healing.
Choice B reason: Potassium is not a dietary supplement that can help with wound healing, although it is essential for nerve and muscle function and fluid balance. Potassium deficiency can cause weakness, fatigue, arrhythmias, and muscle cramps, but it does not affect wound healing.
Choice C reason: Vitamin C is a dietary supplement that can help with wound healing, as it is involved in collagen synthesis, tissue repair, and immune response. Vitamin C deficiency can cause scurvy, which is characterized by bleeding gums, poor wound healing, and anemia.
Choice D reason: Vitamin D is not a dietary supplement that can help with wound healing, although it is necessary for calcium absorption, bone health, and immune function. Vitamin D deficiency can cause rickets, osteomalacia, and increased risk of infections, but it does not affect wound healing.
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