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 ["A","B","C","E"]
Explanation
A. Chocolate can relax the lower esophageal sphincter (LES), allowing stomach acid to reflux into the esophagus and exacerbate symptoms. Therefore, it is advisable for clients with GERD to avoid chocolate.
B. Tomato-based products are acidic and can aggravate GERD symptoms. Tomatoes are naturally acidic, which can contribute to increased acidity in the stomach and exacerbate reflux symptoms.
C. Spicy and high-fat foods, such as hot and spicy pork rinds, can trigger GERD symptoms by increasing stomach acid production and relaxing the LES. Spicy foods can irritate the esophagus and exacerbate symptoms such as heartburn and reflux.
E. Oranges and other citrus fruits are acidic and can irritate the esophagus, exacerbating GERD symptoms. The acidity in oranges can increase stomach acid production and contribute to reflux.
D. Green beans are generally considered safe for individuals with GERD. They are low in fat and acidity, making them less likely to trigger reflux symptoms.
Correct Answer is D
Explanation
D. Anuria refers to the absence of urine production, which can occur due to urinary tract obstruction, severe dehydration, or renal failure. In the context of a client attempting to pass a kidney stone, anuria would be a concerning sign indicating potential urinary tract obstruction requiring urgent medical attention.
A. Renal colic refers to severe flank pain caused by the passage of a kidney stone through the urinary tract. While renal colic is a common symptom of kidney stones and can cause significant discomfort, it does not necessarily indicate an emergency situation unless it is associated with complications such as obstructive uropathy or infection.
B. Hematuria, or blood in the urine, is a common finding in individuals with kidney stones. It occurs due to irritation or injury to the urinary tract as the stone passes through.
C. Nausea is a common symptom experienced by individuals with kidney stones, particularly if there is associated pain or discomfort. While nausea can be distressing, it does not typically indicate an emergency situation unless it is severe and persistent, leading to dehydration or other complications.
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