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 C

Explanation

Choice A Reason
Metoprolol, a beta-blocker, can cause fluid retention, which may lead to swelling in the ankles. However, this is not a common side effect and is not typically included as a standard warning for patients starting on metoprolol. Patients should be aware of this potential side effect but also understand that it may not occur.

Choice B Reason
Patients should not stop taking metoprolol abruptly, especially if they experience fatigue, which can be a common side effect. Abrupt cessation can lead to rebound hypertension or angina. Instead, patients should consult their healthcare provider if they experience significant fatigue that impacts their daily activities.

Choice C Reason
Checking the pulse is an important self-monitoring measure for patients on metoprolol. This medication can slow the heart rate, and patients should be instructed on how to check their pulse and what to do if it falls below a certain rate, as advised by their healthcare provider.

Choice D Reason
While staying hydrated is generally good advice, there is no specific need to drink plenty of fluids related to the use of metoprolol for angina pectoris. Patients should follow normal hydration guidelines unless otherwise directed by their healthcare provider.

A. Move into a side-lying position with the head elevated. B. Lay in the Trendelenburg position. C. Lean over the bedside table. D. Sit in Fowler's position with heels off the bed.

Correct Answer is C

Explanation

Choice A Reason:
A side-lying position with the head elevated may provide some comfort but is not the most effective position for reducing the work of breathing in emphysema patients. This position does not maximize lung expansion or aid in the optimal use of respiratory muscles.

Choice B Reason:
The Trendelenburg position, where the body is laid flat on the back with the feet higher than the head, is not recommended for emphysema patients as it can increase the pressure on the diaphragm, making breathing more difficult.

Choice C Reason:
Leaning over the bedside table, often referred to as the tripod position, is beneficial for emphysema patients. This position allows for the optimal use of respiratory muscles and helps to reduce the work of breathing by supporting the arms and allowing the shoulder girdle muscles to assist in the breathing process.

Choice D Reason:
Fowler's position, where the patient is seated with the legs either bent or straight out in front, may not be as effective as the tripod position for emphysema patients. While it does allow for better lung expansion than lying flat, it does not provide the same level of support for the respiratory muscles as leaning forward does.

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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

The nurse is providing discharge teaching to a client with angina pectoris who is prescribed metoprolol 50 mg PO daily. Which information should the nurse include in the teaching?

Correct Answer is C

Explanation

A client diagnosed with emphysema states that it is uncomfortable to sit in a semi-Fowler's position. In order to best decrease the work of breathing, the nurse should assist the client to:

Correct Answer is C

Explanation

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The nurse identifies that the goal of decreasing the cardiac workload for a client receiving atenolol 25 mg PO BID for unstable angina is met when the client has:

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