The nurse is caring for a client receiving a TPN Infusion running at 54.2 mL/hr and there is only 25 mL remaining in the bag. The next Infusion bag has not been brought to the unit. Which action would be appropriate?
Notify the physician immediately.
Notify the pharmacy when the bag is empty
Decrease the rate to 27.1 mL/hr until the new bag is brought to the unit
Hang a bag of D10W at the current rate until the new bag arrives
The Correct Answer is C
C. Decrease the rate to 27.1 mL/hr until the new bag is brought to the unit: This option is a suitable approach to conserve the remaining TPN solution until the new bag arrives. By halving the infusion rate, the remaining volume of TPN will last longer, ensuring the client continues to receive some nutrition and fluid support while awaiting the delivery of the new bag.
A. While it's important to inform the healthcare team about the low volume of TPN remaining, it may not require immediate physician intervention unless the situation worsens or alternative actions need to be taken.
B. Notifying the pharmacy when the bag is empty is a reasonable action, as they can prepare and deliver the next infusion bag promptly. However, it does not address the immediate need for fluid and nutrition replacement.
D. D10W (dextrose 10% in water) can help prevent hypoglycemia and provide some energy, but it does not provide the full nutritional support that TPN does. However, it can be a reasonable short- term measure while waiting for the replacement TPN bag.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B. Taking pantoprazole before the first meal of the day allows for optimal acid suppression during the period of increased gastric acid production after waking up. This timing helps maximize the medication's effectiveness in reducing stomach acid and promoting ulcer healing.
A. Pantoprazole is a proton pump inhibitor (PPI) medication used to reduce stomach acid production and promote healing of gastric ulcers. It is typically taken once daily, usually in the morning before the first meal of the day. Taking pantoprazole before bedtime may not provide optimal acid suppression throughout the day when gastric acid production is typically higher.
C. Pantoprazole does not coat the ulcer; rather, it works by inhibiting the proton pumps in the stomach lining that produce acid. By reducing acid production, pantoprazole helps to create an environment in which the ulcer can heal more effectively.
D. While some individuals with conditions such as gastroesophageal reflux disease (GERD) or chronic gastric ulcers may require long-term or even lifelong pantoprazole therapy to manage their symptoms and prevent ulcer recurrence, the duration of treatment varies depending on the underlying condition, the severity of symptoms, and the response to treatment.
Correct Answer is D
Explanation
D. Pregnancy is a known risk factor for gallstone formation and cholecystitis. Hormonal changes during pregnancy, particularly increased levels of estrogen, can lead to increased cholesterol saturation in bile, decreased gallbladder emptying, and increased risk of gallstone formation.
A. Fiber helps to regulate bowel movements and may decrease cholesterol levels in bile, thereby reducing the likelihood of gallstone formation.
B. Pregnancy itself can predispose individuals to gallstone formation due to hormonal changes that increase cholesterol saturation in bile. However, normal weight gain reduces the risk of cholecystitis.
C. Certain ethnicities, including individuals of Native American, Hispanic, and African-American ancestry, have a higher prevalence of gallstones compared to other populations. However, ethnicity alone may not be a direct cause of acute cholecystitis.
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