Which intervention is most important for the practical nurse (PN) to implement for a client who is receiving total parenteral nutrition (TPN)?
Collect fingerstick glucose levels
Implement bleeding precautions
Obtain daily weights
Check urine for albumin
The Correct Answer is A
a) Collect fingerstick glucose levels. Correct
Collecting fingerstick glucose levels is the most important intervention for the PN to implement for a client who is receiving TPN. TPN is a method of feeding that bypasses the gastrointestinal tract and provides all the nutritional needs of the body through a vein. TPN contains a high concentration of glucose, which can cause hyperglycemia or fluctuations in blood sugar levels. Therefore, it is essential to monitor the client's glucose levels frequently and adjust the infusion rate or insulin administration accordingly.
b) Implement bleeding precautions.
Implementing bleeding precautions is not the most important intervention for the PN to implement for a client who is receiving TPN. Bleeding precautions are measures to prevent or minimize bleeding in clients who have a high risk of hemorrhage due to conditions such as thrombocytopenia, coagulopathy, or anticoagulant therapy. TPN does not directly increase the risk of bleeding, although it may affect the liver function and clotting factors in some cases². Therefore, bleeding precautions are not a priority for a client who is receiving TPN.
c) Obtain daily weights.
Obtaining daily weights is not the most important intervention for the PN to implement for a client who is receiving TPN. Obtaining daily weights is a way to monitor the client's fluid balance, nutritional status, and response to therapy. TPN can cause fluid overload, dehydration, or electrolyte imbalances in some cases²⁵. Therefore, obtaining daily weights is important, but not as important as monitoring glucose levels.
d) Check urine for albumin.
Checking urine for albumin is not the most important intervention for the PN to implement for a client who is receiving TPN. Checking urine for albumin is a way to detect proteinuria, which is an indicator of kidney damage or disease. TPN does not directly cause kidney problems, although it may affect the renal function and urine output in some cases². Therefore, checking urine for albumin is not a priority for a client who is receiving TPN.
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Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Developing a survey on teen pregnancies is not an appropriate action by the nurse because it does not address the issue of influenza A outbreak in the school, which can affect students of any age or gender.
Choice B reason: Holding a focus group to discuss immunizations is an appropriate action by the nurse because it can educate and inform parents and students about the benefits and risks of influenza vaccination, as well as encourage them to get vaccinated before or during flu season.
Choice C reason: Running a mandatory flu clinic is not an appropriate action by the nurse because it can violate the rights and autonomy of parents and students who may have medical or personal reasons for refusing influenza vaccination, as well as create resentment and resistance among them.
Choice D reason: Closing the school for 6 weeks is not an appropriate action by the nurse because it can disrupt the education and socialization of students, as well as cause economic and logistic problems for parents and teachers. The recommended duration of school closure for influenza A outbreak is 5 to 7 days, which is the typical incubation period of the virus.
Correct Answer is D
Explanation
Choice A reason: Natural history of disease is not an approach that explains the factors that allow the reproduction and spread of infectious disease, but rather a description of how a disease progresses over time from exposure to outcome in the absence of intervention.
Choice B reason: Health promotion is not an approach that explains the factors that allow the reproduction and spread of infectious disease, but rather a process of enabling people to increase control over and improve their health through education, empowerment, and policy changE.
Choice C reason: Levels of prevention are not an approach that explains the factors that allow the reproduction and spread of infectious disease, but rather a classification of interventions based on their timing and purpose in relation to disease occurrencE.
Choice D reason: Epidemiologic triangle is an approach that explains the factors that allow the reproduction and spread of infectious disease, by identifying and analyzing three elements: agent (the cause of disease), host (the person who gets sick), and environment (the conditions that affect transmission).
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