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

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. Parenteral nutrition (PN) should not be left out for extended periods. Generally, unused PN should be discarded after 24 hours, not 12 hours, to prevent contamination and bacterial growth.
B. The flow rate of PN should be monitored and adjusted carefully, but it should not be increased without orders. Rapid adjustments could cause complications such as fluid overload or electrolyte imbalances.
C. PN solution should be removed from the refrigerator 1 to 2 hours before use to allow it to come to room temperature, but 2 hours may be too long. It should be done cautiously to avoid bacterial growth at room temperature.
D. Monitoring daily laboratory values is essential for assessing the client's nutritional status, electrolytes, liver function, and kidney function. These values help guide ongoing care and detect complications of PN, such as electrolyte imbalances or liver dysfunction.

A. Taking all drugs one hour before mealtime to prevent complications B. Limiting alcohol intake to one to two servings per day C. Avoiding taking aspirin and drugs containing aspirin D. Only take aspirin with milk or bread products E. Only taking drugs prescribed by the healthcare provider

Correct Answer is ["C","E"]

Explanation

A. Taking all drugs one hour before mealtime is not typically recommended for patients recovering from upper G.I. bleeding. Medications like proton pump inhibitors or antacids may be prescribed to reduce stomach acid, but timing varies. The patient should follow the specific instructions given by the healthcare provider regarding medication administration, especially in the context of G.I. issues.
B. Limiting alcohol intake is important for general health, but after an episode of upper G.I. bleeding, alcohol should be avoided or minimized entirely. Alcohol can irritate the stomach lining and increase the risk of further bleeding. The healthcare provider may recommend complete abstinence from alcohol during recovery.
C. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can cause irritation of the stomach lining and increase the risk of bleeding, so they should be avoided after an episode of upper G.I. bleeding. This is crucial for preventing recurrence of bleeding.
D. Taking aspirin with milk or bread does not negate its potential for irritation or bleeding risk. Patients recovering from upper G.I. bleeding should avoid aspirin entirely unless specifically directed otherwise by the healthcare provider.
E. Only taking drugs prescribed by the healthcare provider is essential. Over-the-counter medications, especially NSAIDs, should be avoided unless directed by a healthcare provider, as they can exacerbate the risk of further G.I. bleeding.

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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.)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has Crohn's disease and is receiving parenteral nutrition. Which of the following interventions should the nurse include in the care of this client?

Correct Answer is D

Explanation

The nurse is preparing a teaching plan for a patient being discharged after an acute episode of upper G.I. bleeding. What important information should the teaching plan include? Select all that apply.

Correct Answer is ["C","E"]

Explanation

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