A patient with anorexia nervosa shows signs of malnutrition and is prescribed parenteral nutrition. If the client develops refeeding syndrome, what laboratory tests does the nurse expect the healthcare provider to order? (Select all that apply.)
Serum phosphorus
Serum blood glucose
Serum calcium
Serum potassium
Serum magnesium
Correct Answer : A,C,D,E
A. Serum phosphorus is crucial to monitor in patients at risk for refeeding syndrome. Hypophosphatemia is a key sign of the syndrome and can lead to severe complications, such as respiratory failure and cardiac arrhythmias.
B. Serum blood glucose levels are important to monitor, especially since refeeding syndrome can cause rapid shifts in glucose metabolism. However, it is not a primary test to diagnose refeeding syndrome. Blood glucose monitoring will be part of the overall management, but not the core test for the syndrome.
C. Serum calcium should be monitored because it can also decrease in refeeding syndrome due to shifts in phosphate and magnesium levels, which may affect calcium metabolism.
D. Serum potassium is essential to monitor because hypokalemia often occurs in refeeding syndrome as the body shifts electrolytes into cells. This can cause muscle weakness, arrhythmias, and other serious complications.
E. Serum magnesium is also important to check, as hypomagnesemia is commonly seen in refeeding syndrome and can contribute to neurological and cardiac symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
A. A family history of esophageal cancer is a known risk factor. Genetic factors can increase the likelihood of developing esophageal cancer, especially if close family members have had the condition.
B. A diet high in glucose is not specifically associated with an increased risk of esophageal cancer. However, poor dietary habits in general, such as a high intake of processed foods or low fiber, can contribute to other health issues.
C. Irregular exercise is not a major risk factor for esophageal cancer. However, a lack of physical activity can contribute to overall health problems, including obesity, which is a known risk factor for some cancers.
D. Smoking tobacco is a significant risk factor for esophageal cancer. Smoking can damage the esophagus and increase the risk of developing both squamous cell carcinoma and adenocarcinoma of the esophagus.
Correct Answer is A
Explanation
A. The IV tubing for TPN should be changed every 24 hours to prevent infection, as TPN is a high-risk solution for bacterial growth due to its high glucose content. Regular changes help reduce the risk of contamination and complications such as bloodstream infections.
B. The IV site dressing should be changed at least every 48 to 72 hours (or per institutional policy) to maintain aseptic technique and minimize infection risk. Changing the dressing every 4 days may exceed this timeframe and increase the risk of infection.
C. Weighing the client is important to monitor fluid balance, but daily weighing is more typical than every other day for clients receiving TPN. This helps to assess nutritional status and detect potential fluid overload or deficit.
D. Blood glucose levels should be monitored more frequently, typically every 6 hours, because TPN can cause significant fluctuations in blood glucose. Checking every 12 hours would not be adequate for early detection of hyperglycemia or hypoglycemia.
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