Anune is assessing a client who is receiving total parenteral nutrition (TPN). The nurse should identify which of the following findings as an adverse effect of TPN?

Choice A reason: Dry eyes are not caused by vitamin D deficiency, but by other factors such as aging, medication, environmental conditions, or eye diseases. Vitamin D does not have a direct role in eye health or function.

Choice B reason: Fractures are caused by vitamin D deficiency, as vitamin D helps the body absorb calcium, which is essential for bone health and strength. Vitamin D deficiency can lead to osteoporosis, a condition in which the bones become brittle and prone to breaking.

Choice C reason: Infection is not caused by vitamin D deficiency, but by other factors such as exposure to pathogens, weakened immune system, or poor hygiene. Vitamin D may have some role in modulating immune responses, but it is not a primary factor in preventing infection.

Choice D reason: Swelling is not caused by vitamin D deficiency, but by other factors such as injury, inflammation, fluid retention, or allergic reaction. Vitamin D does not have a direct role in regulating fluid balance or reducing inflammation.

Choice A reason: Offering the client frozen banana as a snack is an appropriate intervention for the nurse to take because it can help reduce nausea and stimulate appetite. Frozen banana is cold, bland, and easy to digest, which are characteristics of antiemetic foods. Frozen banana also provides potassium, vitamin C, and fiber for the client.

Choice B reason: Serving the client hot meals is not an appropriate intervention for the nurse to take because it can worsen nausea and vomiting. Hot meals are aromatic, spicy, and greasy, which are characteristics of emetic foods. Hot meals can also irritate the stomach lining and trigger the gag reflex.

Choice C reason: Avoiding serving sauces or gravies is not an appropriate intervention for the nurse to take because it can cause dehydration and malnutrition. Sauces and gravies are liquid, mild, and moist, which are characteristics of antiemetic foods. Sauces and gravies can also enhance the flavor and texture of bland foods and provide calories and nutrients for the client.

Choice D reason: Discouraging the use of a straw is not an appropriate intervention for the nurse to take because it can prevent adequate fluid intake and hydration. Using a straw can help the client sip small amounts of clear liquids, such as water, ginger ale, or broth, which are antiemetic fluids. Using a straw can also reduce the exposure to odors and tastes that may cause nausea.