The nurse is caring for a client receiving total parenteral nutrition (TPN). The nurse understands that the best explanation for utilizing TPN is to:
assist clients who are unable to eat but have active GI function.
give short term nutrition after a surgical procedure.
provide all of the client's nutritional needs in a hypertonic solution.
prevent complications after a laparotomy for a bowel obstruction.
The Correct Answer is C
C. TPN does provide all of the client's nutritional needs, including carbohydrates, proteins, fats, vitamins, minerals, and electrolytes, in a hypertonic solution. The hypertonicity of the solution is necessary to prevent fluid overload and ensure compatibility with the vasculature. The hypertonic solution allows for higher nutrient concentrations to be delivered without exceeding vascular capacity.
A. TPN is indicated for clients who are unable to tolerate enteral nutrition (feeding through the gastrointestinal tract) or have impaired absorption, digestion, or utilization of nutrients despite having active GI function.
B. TPN may be used temporarily after a surgical procedure if the client is unable to tolerate oral or enteral feeding or if enteral nutrition is contraindicated due to the surgical site or condition. However, TPN is not limited to short-term use after surgery and may be required for an extended period in clients with chronic conditions or prolonged inability to tolerate enteral nutrition.
D. TPN may be used in some cases after a laparotomy for a bowel obstruction, particularly if enteral nutrition is contraindicated or if the client is unable to tolerate oral intake. However, TPN is not primarily used to prevent complications after surgery but rather to provide nutritional support when enteral feeding is not feasible or sufficient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Sit the client up and provide supplemental oxygen is the correct priority intervention. Chest pain and shortness of breath can be indicative of pulmonary embolism or other respiratory complications, which require immediate attention. Sitting the client up helps improve respiratory mechanics, and providing supplemental oxygen can support oxygenation while further assessments are conducted.
B. While contacting the physician and obtaining an arterial blood gas may be necessary to assess respiratory status and oxygenation, it is not the immediate priority. The client's symptoms require immediate intervention to ensure adequate oxygenation and prevent further deterioration.
C. Chest pain and shortness of breath are not typically expected findings after bariatric surgery and could indicate serious complications. It is essential not to dismiss the client's symptoms but to take them seriously and initiate appropriate interventions.
D. While the use of an incentive spirometer is important for preventing respiratory complications after surgery, it is not the priority intervention in this situation. The client's current symptoms require immediate attention to address potential respiratory distress or other serious complications.
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.
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