Choose appropriate interventions to stabilize the patient with acute anemia. Select all that apply.

Choice A reason: Hypoglycemia typically presents with symptoms such as sweating, trembling, hunger, confusion, and in severe cases, loss of consciousness. The patient's symptoms of sudden right-sided weakness and difficulty speaking are more consistent with a neurological event rather than low blood sugar levels.

Choice B reason: Hemorrhagic stroke involves bleeding within the brain. Although it can present with similar symptoms to ischemic stroke, the diagnostic tests indicate no evidence of hemorrhage. This makes a hemorrhagic stroke less likely.

Choice C reason: Ischemic stroke occurs when a blood clot blocks a blood vessel in the brain, leading to reduced blood flow and oxygen to a part of the brain. The patient's symptoms of sudden right-sided weakness and expressive aphasia are classic signs of an ischemic stroke, and the absence of hemorrhage on the head CT scan supports this diagnosis.

Choice D reason: Multiple sclerosis (MS) is a chronic, progressive disease that affects the central nervous system. It usually presents with episodic neurological symptoms rather than the sudden onset seen in this patient. MS symptoms develop over time and can vary widely, whereas the patient's acute presentation is more indicative of a stroke.

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.