The nurse is preparing to hang the client's next bag of Total Parenteral Nutrition (TPN) and observes fat globules rising to the top of the solution. What action should the nurse take?

Run the bag under warm water to melt the globules.

Call the pharmacy to get a new bag of TPN.

Do nothing, as fat globules are expected to rise to the top of the TPN solution.

Roll the bag of solution gently to redistribute the fat.

Answer and Explanation

The Correct Answer is B

Choice A Reason
Running the bag under warm water to melt the globules is not recommended. Applying heat could compromise the sterility and integrity of the solution. TPN solutions are carefully balanced and sterile, and any manipulation involving temperature changes could lead to contamination or nutrient degradation.

Choice B Reason
Observing fat globules at the top of the TPN solution is a sign that the emulsion may be compromised. The nurse should not administer this TPN solution and should call the pharmacy for a replacement. TPN solutions should be homogenous with no visible separation or fat globules to ensure the patient receives the correct nutrition and to prevent complications.

Choice C Reason
Doing nothing is not an appropriate action. Fat globules indicate that the solution has separated, which can lead to an unstable emulsion and potential harm if infused. The nurse's responsibility is to ensure the safety and efficacy of the treatment, which includes verifying that TPN solutions are properly mixed.

Choice D Reason
Rolling the bag gently to redistribute the fat is not a safe practice. While gentle agitation can be used for some medications, it is not appropriate for TPN solutions with visible fat globules. This could further destabilize the emulsion and does not address the underlying issue of separation.

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Correct Answer is A

Explanation

Choice A reason:
Duloxetine is a medication that should not be stopped abruptly due to the risk of withdrawal symptoms. Gradual tapering is recommended to minimize these symptoms. This understanding by the client indicates effective medication teaching.

Choice B reason:
The statement about the medication being safe with herbal supplements is incorrect. Patients should consult their healthcare provider before using herbal supplements with duloxetine, as there can be interactions.

Choice C reason:
The need to avoid aged cheese is associated with monoamine oxidase inhibitors (MAOIs), not duloxetine, which is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). This statement does not reflect accurate medication teaching for duloxetine.

Choice D reason:
Taking extra doses for anxiety without consulting a healthcare provider is not recommended. Duloxetine dosing should be consistent and as prescribed by a healthcare provider. This statement suggests a misunderstanding of medication management.

A. Petechiae on the chest. B. An edematous calf. C. Elevated temperature. D. Paresthesia distal to the fracture.

Correct Answer is A

Explanation

Choice A Reason
Petechiae on the chest are a classic sign of fat emboli syndrome (FES). FES is a rare but serious complication that can occur after a long bone fracture, such as a femur fracture. The petechiae result from small fat droplets that travel to the skin's capillaries and cause pinpoint hemorrhages. This symptom is part of the classic triad for FES, which includes respiratory distress, neurological symptoms, and a petechial rash.

Choice B Reason
While an edematous calf may be a concern for deep vein thrombosis or other complications following a fracture, it is not a specific indicator of FES. Edema in the calf could be due to various reasons, including local trauma from the fracture itself or immobilization.

Choice C Reason
An elevated temperature can be associated with many post-injury complications, including infection or inflammatory response. However, it is not specific to FES. While patients with FES may present with fever, it is not one of the primary diagnostic criteria.

Choice D Reason
Paresthesia distal to the fracture could indicate nerve damage or compartment syndrome, which are important to assess in a patient with a femur fracture. However, paresthesia is not a specific sign of FES. The neurological symptoms associated with FES are more generalized and often include confusion or altered mental status.

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The nurse is preparing to hang the client's next bag of Total Parenteral Nutrition (TPN) and observes fat globules rising to the top of the solution. What action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client diagnosed with depression is prescribed duloxetine. Which statement made by the client would allow the nurse to assess that the medication teaching has been effective?

Correct Answer is A

Explanation

Which assessment finding indicates to the nurse that the client who sustained a fractured femur in a motor vehicle accident is experiencing fat emboli syndrome?

Correct Answer is A

Explanation

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