Which of the following is are appropriate nursing interventions to ensure the safety of a patient who is receiving Total Parenteral Nutrition (TPN)? (Select all that apply)

TPN should flow through a filtered IV line

No other drugs should be infused through the TPN line

If TPN gets stopped or runs out, hang a bag of D10% W

TPN IV tubing and bag should be changed every 24 hrs

TPN should be administered through a central line

Answer and Explanation

Correct Answer : A,B,D,E

A.   Using a filtered IV line helps remove any particulate matter that could be present in the TPN solution, reducing the risk of complications such as phlebitis or embolism.
B.   TPN should have its own dedicated line to prevent incompatibilities and ensure the TPN solution is delivered without interference. Infusing other medications through the same line can lead to complications and reduce the effectiveness of TPN.
C.   If TPN gets stopped or runs out, a bag of 5% dextrose in water (D5W) should be hung to prevent hypoglycemia. D10% is too concentrated and can cause hyperglycemia.
D.   To minimize the risk of infection and maintain sterility, TPN bags and tubing should be replaced every 24 hours. This helps prevent bacterial growth in the TPN solution.
E.   TPN is typically administered through a central line because it allows for the infusion of hypertonic solutions that can irritate peripheral veins. Central lines provide better access to larger blood vessels, reducing the risk of complications.

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Correct Answer is B

Explanation

A. While anemia is a common finding in aplastic anemia, it is not the most comprehensive answer. Aplastic anemia results in a deficiency of all blood cell types due to bone marrow failure, so while anemia is present, it does not fully capture the extent of the disorder.
B. This is the most accurate choice. Pancytopenia refers to the simultaneous reduction of red blood cells, white blood cells, and platelets. In aplastic anemia, the bone marrow fails to produce adequate blood cells, leading to this triad of cytopenias, making it the hallmark of the disease.
C. Neutropenia, which is a low level of neutrophils (a type of white blood cell), can occur in aplastic anemia. However, it is only one component of the broader condition and does not represent the complete picture of the disease.
D. Leukopenia refers to a low white blood cell count. Like neutropenia, it can be a finding in aplastic anemia, but it does not encompass the anemia and thrombocytopenia that also occur.

A. Morphine Sulfate 4 mg IV ATC B. Fentanyl 25 mcg/hr transdermal patch Now C. Ibuprofen 800 mg PO D. Hydromorphone liquid 5 mg PO

Correct Answer is A

Explanation

A. Morphine is a strong opioid analgesic that is effective for managing severe pain, especially in acute situations like a vaso-occlusive crisis. Administering it intravenously allows for rapid onset of pain relief, which is critical given the severity of the patient’s symptoms. Continuous dosing (ATC—around the clock) ensures that pain is managed effectively.
B. Fentanyl patches are typically used for chronic pain management and take time to reach effective levels in the bloodstream (up to 12 hours or longer). In the case of acute severe pain from a vaso- occlusive crisis, this option would not provide immediate relief.
C. While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can help relieve mild to moderate pain, it is not adequate for severe pain management. Additionally, in the setting of sickle cell disease, patients may be at risk for renal issues, making high doses of NSAIDs potentially harmful.
D. Hydromorphone is also a strong opioid analgesic; however, administering it orally may not be effective for severe pain management in an acute situation. IV administration of opioids is preferred for immediate and potent pain relief during a vaso-occlusive crisis.

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Which of the following is are appropriate nursing interventions to ensure the safety of a patient who is receiving Total Parenteral Nutrition (TPN)? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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