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
A. While it may have some impact on kidney function indirectly through its effects on blood pressure and heart function, urine output is not the primary parameter used to assess the effectiveness of carvedilol in a patient with a history of unstable angina.
B. Carvedilol, as a beta-blocker, helps reduce heart rate by blocking the effects of adrenaline on the heart. In unstable angina, lowering the heart rate can reduce myocardial oxygen demand, which is beneficial in managing ischemic symptoms
C. Carvedilol primarily affects heart rate and blood pressure but doesn't directly regulate heart rhythm. However, in patients with certain cardiac conditions, like heart failure or left ventricular dysfunction after a heart attack, carvedilol can sometimes help to stabilize heart rhythm indirectly by reducing stress on the heart.
D. Carvedilol is also effective in reducing blood pressure, which is beneficial in patients with unstable angina, as it decreases the workload on the heart and the oxygen demand of the myocardium. A blood pressure reading of 120/90 is within the normal range for an adult and indicates good control of blood pressure.
Correct Answer is C
Explanation
A. This statement reflects an understanding that medications such as orlistat are typically prescribed as an adjunct to lifestyle changes, including diet and exercise. It is important for clients to attempt lifestyle modifications before resorting to medication for weight loss. Therefore, this statement demonstrates appropriate knowledge.
B. Orlistat, a medication used for weight loss, can cause gastrointestinal side effects such as oily spotting, flatulence with discharge, fecal urgency, and oily or fatty stools.
C. Orlistat is not typically used as a long-term treatment for weight loss. It is usually prescribed for a limited duration to aid in initial weight loss efforts or to help maintain weight loss achieved through lifestyle modifications.
D. Orlistat has been shown to lead to modest weight loss in clinical studies, typically ranging from about 6-11 pounds (2.7-5 kg) over 6-12 months when used in conjunction with lifestyle modifications. However, individual weight loss outcomes can vary, and it is important for clients to have realistic expectations regarding the effectiveness of weight loss medications.
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