While caring for a client receiving total parenteral nutrition (TPN), it is most important for the nurse to monitor which of the client's lab values?

Choice A

Planning low carbohydrate and high protein meals is not recommended. While meal planning is important for weight loss, focusing solely on low carbohydrate and high protein meals may not be the most balanced or sustainable approach. It's essential to consider a variety of nutrients and food groups in the diet.

Choice B

Engaging in strenuous activity for an hour daily is not recommended. Jumping into strenuous activity for an hour daily might not be realistic or safe for everyone, especially for someone who is just starting their weight loss journey. A more gradual increase in physical activity is often recommended.

Choice C

Participating in a group exercise class 3 times a week is not recommended. Group exercise classes can be beneficial, but they may not address the whole spectrum of weight loss factors. Additionally, starting with three times a week might be challenging for someone new to exercise.

Choice D

Keep a record of food and drinks consumed daily is recommended. When helping a client with a BMI of 30 (which falls within the obese range) start a weight loss plan, keeping a record of food and drinks consumed daily can be an effective initial approach. This approach is often referred to as "food journaling" or "food tracking." It involves writing down everything the client eats and drinks throughout the day. This practice can help raise awareness of eating habits, identify patterns, and uncover areas where changes can be made to reduce calorie intake.

Choice A

Urinary ketones are not most important. Monitoring urinary ketones can provide information about the utilization of glucose and fat as energy sources. However, it is not the primary lab value to monitor in TPN administration.

Choice B

Serum protein is not most important. Monitoring serum protein levels is important to assess nutritional status, but it might not be as immediate a concern as serum osmolarity.

Choice C

Serum osmolarity is the most important. When caring for a client receiving total parenteral nutrition (TPN), monitoring serum osmolarity is most important. TPN is a highly concentrated solution containing various nutrients, and it is infused directly into the bloodstream. Serum osmolarity reflects the concentration of particles (such as electrolytes, glucose, and other solutes) in the blood. Monitoring serum osmolarity is crucial to prevent complications related to fluid and electrolyte imbalances that can arise from the administration of TPN.

Choice D

Capillary glucose is not the most important. Monitoring capillary glucose levels is important, especially in clients receiving TPN with added glucose. Hyperglycaemia is a potential complication of TPN. While glucose monitoring is important, it is secondary to monitoring serum osmolarity, which encompasses a broader range of solute concentrations.