The nurse is initiating Total Parenteral Nutrition (TPN) to a postoperative patient after a proctocolectomy. What actions will the nurse initiate to begin this therapy when caring for this patient?

Start with a rapid infusion rate to meet the patient's nutritional needs as quickly as possible.

Initiate the infusion slowly and monitor the patient's fluid and glucose tolerance.

Change the rate of administration every 4 hours based on serum electrolyte values.

Increase the rate of infusion at mealtimes to mimic the circadian rhythm of the body.

Answer and Explanation

The Correct Answer is B

Choice A reason: Starting with a rapid infusion rate to meet the patient's nutritional needs as quickly as possible is not recommended. Rapid infusion can cause complications such as fluid overload, hyperglycemia, and electrolyte imbalances. It is important to start TPN at a slow rate and gradually increase it as tolerated.

Choice B reason: Initiating the infusion slowly and monitoring the patient's fluid and glucose tolerance is the appropriate action. This allows the nurse to assess the patient's response to TPN, prevent complications, and make necessary adjustments to the infusion rate.

Choice C reason: Changing the rate of administration every 4 hours based on serum electrolyte values is not a standard practice. The rate should be adjusted based on the patient's overall tolerance and clinical condition, rather than frequent changes.

Choice D reason: Increasing the rate of infusion at mealtimes to mimic the circadian rhythm of the body is not appropriate for TPN. TPN is typically administered continuously over 24 hours to provide steady nutrition and prevent complications.

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Correct Answer is ["A","B","D"]

Explanation

Choice A reason: Candidiasis, or oral thrush, is a common side effect of inhaled corticosteroids like budesonide. Patients should be educated on the importance of rinsing their mouth after using the inhaler to reduce the risk of this fungal infection.

Choice B reason: Dysphonia, or hoarseness, is another potential side effect of budesonide inhalers. This occurs due to the medication's effect on the vocal cords and can be minimized by using a spacer and rinsing the mouth after inhalation.

Choice C reason: Weight loss is not a common side effect of inhaled budesonide. Inhaled corticosteroids typically do not affect body weight in the same way that systemic corticosteroids might.

Choice D reason: Headache is a potential side effect of budesonide inhalers. Patients should be informed about this possibility and advised to manage headaches with appropriate over-the-counter medications if needed.

A. Osteoarthritis B. Osteoporosis C. Hyperglycaemia D. Mucositis

Correct Answer is ["B","C"]

Explanation

Choice A reason: Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage and underlying bone. It is not directly associated with corticosteroid treatment. Osteoarthritis develops due to wear and tear over time, and while corticosteroids are used to manage inflammation, they do not cause osteoarthritis.

Choice B reason: Osteoporosis is a potential complication of long-term corticosteroid use. Corticosteroids can interfere with bone formation and increase the rate of bone resorption, leading to decreased bone density and an increased risk of fractures. Patients on long-term corticosteroid therapy should be monitored for signs of osteoporosis, and preventive measures such as calcium and vitamin D supplementation may be recommended.

Choice C reason: Hyperglycaemia, or elevated blood glucose levels, is a common side effect of corticosteroid therapy. Corticosteroids can increase insulin resistance and promote glucose production in the liver, leading to higher blood sugar levels. Patients with diabetes or those at risk for diabetes should be closely monitored for changes in their blood glucose levels when on corticosteroid therapy.

Choice D reason: Mucositis, or inflammation of the mucous membranes, is not a typical complication of corticosteroid therapy. Mucositis is more commonly associated with chemotherapy or radiation therapy used in cancer treatment. While corticosteroids can affect the immune system, they do not directly cause mucositis.

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The nurse is initiating Total Parenteral Nutrition (TPN) to a postoperative patient after a proctocolectomy. What actions will the nurse initiate to begin this therapy when caring for this patient?

Nursing Test Bank

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