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 D

Explanation

A. Prednisone can lead to sodium and fluid retention, which can result in hypertension and edema. While this is an important consideration, it is not the most critical point to emphasize initially. Managing weight and blood pressure is essential, but there are more immediate concerns with the medication's use.
B. Long-term use of prednisone can result in changes such as fat redistribution, leading to a "moon face," buffalo hump, and increased abdominal fat. This is significant for understanding the side effects of prolonged therapy, but it is not the most urgent information for the client to know.
C. Prednisone can cause side effects such as mood changes, anxiety, or jitteriness, especially when initiating treatment or adjusting dosages. While this is relevant, the potential for emotional or psychological effects is secondary to the critical management of the medication.
D. This is the most critical point to emphasize. Prednisone is a corticosteroid that can suppress the body's natural adrenal function. Abrupt discontinuation can lead to adrenal crisis, which can be life- threatening.

A. "I will rinse raw fruits with water before eating them" B. “I will wear gloves while changing the kitty litter box" C. "I will wear a N95 mask when around sick family members" D. “I will cook vegetables before eating them"

Correct Answer is B

Explanation

A. While rinsing fruits is good practice, it may not fully eliminate the risk of pathogens, especially for someone with a compromised immune system.
B. This statement is the best indication of understanding how to prevent infections. Changing kitty litter can expose the client to Toxoplasma gondii, which is particularly risky for immunocompromised individuals. Wearing gloves is a direct and effective precaution.
C. Although wearing an N95 mask can be appropriate in certain situations, it may not be necessary for all interactions with sick family members. A standard surgical mask is often sufficient.
D. Cooking vegetables is a good practice for food safety, especially for immunocompromised individuals, but this statement is more general than specifically addressing a particular risk.

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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)

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