A student asks the nurse why a peripherally inserted central catheter is needed for a patient receiving Total Parenteral Nutrition (TPN) with 25% dextrose. Which response by the nurse is accurate?
The required blood glucose monitoring is based on samples obtained from a central line.
There is a decreased risk for infection when 25% dextrose is infused through a central line.
The hypertonic solution will be more rapidly diluted when given through a central line.
The prescribed infusion can be given more rapidly when the patient has a central line.
The Correct Answer is C
Choice A reason: While blood glucose monitoring is essential for patients receiving TPN, it is not specifically necessary to obtain samples from a central line. Blood glucose levels can be monitored through peripheral blood samples.
Choice B reason: There is actually an increased risk of infection with central lines compared to peripheral lines due to the invasive nature of central line placement and its location. Proper aseptic technique is critical to minimize this risk.
Choice C reason: The hypertonic solution will be more rapidly diluted when given through a central line. This is a critical point because the central veins have a higher blood flow and larger volume, which helps to quickly dilute the hypertonic TPN solution. This reduces the risk of phlebitis and damage to the smaller peripheral veins, making central lines more suitable for infusing highly concentrated solutions like 25% dextrose.
Choice D reason: While a central line can allow for the rapid administration of infusions, this is not the primary reason for its use with TPN. The key factor is the dilution of the hypertonic solution, as central lines handle high osmolarity solutions better than peripheral veins.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Encouraging the patient to engage in strenuous exercise to improve circulation is not appropriate for someone with thrombocytopenia. Strenuous exercise can increase the risk of injury and bleeding, which is particularly dangerous for patients with a low platelet count.
Choice B reason: Instructing the patient to use an electric razor for shaving is the most appropriate intervention. Thrombocytopenia increases the risk of bleeding, and using an electric razor instead of a traditional blade helps minimize the risk of cuts and subsequent bleeding.
Choice C reason: Teaching the patient to use a water pick for oral hygiene is not recommended for thrombocytopenia patients. Water picks can cause bleeding of the gums, which is a concern for individuals with low platelet counts. Using a soft-bristled toothbrush is safer.
Choice D reason: Requesting an order for subcutaneous heparin to prevent blood clots is not advisable for a thrombocytopenia patient without specific medical indication. Heparin is an anticoagulant, and administering it to someone with low platelets can exacerbate the risk of bleeding.
Correct Answer is C
Explanation
Choice A reason: Stage 2 pressure injuries involve partial-thickness loss of skin with exposed dermis. The wound bed is viable, pink or red, and moist, and may also present as an intact or ruptured serum-filled blister. Since the wound involves subcutaneous tissue, it exceeds the criteria for Stage 2.
Choice B reason: Stage 1 pressure injuries are characterized by non-blanchable erythema of intact skin. While the skin is still intact, it may appear red and not lighten when pressed. Given the description of a wound involving subcutaneous tissue, Stage 1 is not appropriate.
Choice C reason: Stage 3 pressure injuries involve full-thickness loss of skin, where adipose (fat) is visible in the ulcer and granulation tissue and epibole (rolled wound edges) are often present. Slough and/or eschar may be visible, but the depth of tissue damage varies by anatomical location. This aligns with the wound involving subcutaneous tissue.
Choice D reason: Stage 4 pressure injuries involve full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage, or bone. While the wound described involves subcutaneous tissue, there is no mention of deeper tissue involvement, excluding Stage 4 classification.
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