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"I should administer TPN intravenously over 6 hr. TPN is administered continuously over 24 hours using an infusion pump to ensure a steady supply of nutrients and prevent complications such as hyperglycemia or fluid overload. A 6-hour infusion is too rapid and can increase the risk of metabolic imbalances and central line issues.

"Clients who require long-term nutritional support are prescribed TPN." Clients needing long-term nutritional support may receive TPN, but enteral feeding is preferred when the gastrointestinal tract is functional. TPN is typically reserved for clients who cannot digest or absorb nutrients enterally.

"I should check the client's gastric residual prior to initiating TPN." Gastric residual volume checks are associated with enteral nutrition, not TPN. TPN bypasses the gastrointestinal tract and is delivered through a central vein, so gastric residuals are not relevant in this context and should not be assessed before starting TPN.

Diarrhea. Diarrhea is more commonly a cause of potassium loss rather than a direct sign of hypokalemia. While it can lead to hypokalemia over time, it is not a direct indication of low potassium levels. It is a potential cause.

Elevated blood pressure. Hypokalemia typically does not present with elevated blood pressure. In fact, it may cause hypotension due to impaired cardiac muscle function. Elevated blood pressure is not a specific sign pointing toward low potassium levels.

Tetany. Tetany is more commonly associated with hypocalcemia rather than hypokalemia. Although severe electrolyte imbalances can cause neuromuscular excitability, tetany is not a hallmark symptom of low potassium levels.

Hypoglycemia. Furosemide is not typically associated with hypoglycemia. Instead, it can cause hyperglycemia as an adverse effect, especially with prolonged use. Therefore, low blood glucose is not an expected complication of this medication.

Decrease in LDL cholesterol and triglycerides. Furosemide does not reduce LDL cholesterol or triglyceride levels. In fact, it may cause slight increases in lipid levels in some clients. This option does not represent a known adverse effect of the drug.

Blood pressure 138/86 mm Hg. While furosemide is given to reduce fluid overload and lower blood pressure in heart failure, a blood pressure of 138/86 mm Hg is not necessarily an adverse effect. It might even be the desired therapeutic effect. However, if the blood pressure dropped too low (hypotension), that would be an adverse effect.

1100: At 100 mL/hr, only 400 mL would be infused by 1100, meaning the IV bag would still have 600 mL remaining. Therefore, 1100 is too early to expect the need for a new bag.

2200: By 2200, 1,500 mL would have been infused, exceeding the original 1,000 mL in the bag. This time is too late, as the bag would be depleted well before then, risking an interruption in fluid therapy.

1300: At 1300, 600 mL would have been infused, leaving 400 mL in the bag. The nurse would not need to replace the IV bag yet, making this time premature for a bag change.

Respiratory rate 14/min: A respiratory rate of 14 breaths per minute is within the normal adult range of 12 to 20 breaths per minute. This value does not suggest any adverse effect from albuterol and reflects stable respiratory function.

Blood pressure 108/60 mm Hg: This blood pressure reading is within normal limits, especially for a resting adult. It does not indicate hypotension or hypertension and is not associated with albuterol-related adverse effects.

Temperature 38.3° C (101° F): An elevated temperature may indicate infection or inflammation, but it is not a typical side effect of albuterol. Fever is not caused by beta-agonist bronchodilators and would warrant investigation for another underlying cause.

Respiratory rate 14/min: A respiratory rate of 14 breaths per minute is within the normal adult range of 12 to 20 breaths per minute. This value does not suggest any adverse effect from albuterol and reflects stable respiratory function.

Blood pressure 108/60 mm Hg: This blood pressure reading is within normal limits, especially for a resting adult. It does not indicate hypotension or hypertension and is not associated with albuterol-related adverse effects.

Temperature 38.3° C (101° F): An elevated temperature may indicate infection or inflammation, but it is not a typical side effect of albuterol. Fever is not caused by beta-agonist bronchodilators and would warrant investigation for another underlying cause.

Increase the client's dietary intake of vitamin K: Vitamin K is the antidote to warfarin and reduces its effectiveness. Clients on warfarin are usually advised to maintain a consistent, not increased, intake of vitamin K-containing foods. Increasing dietary intake can counteract the drug’s anticoagulant effect and lead to subtherapeutic levels, which increases the risk of clot formation.

Administer protamine sulfate if the client experiences an overdose: Protamine sulfate is the antidote for heparin, not warfarin. Warfarin overdose is treated with vitamin K and possibly fresh frozen plasma, making this an inappropriate response in the case of warfarin toxicity.

Teach the client that St. John's wort increases the effects of the medication: St. John’s wort actually decreases the effectiveness of warfarin by inducing liver enzymes that metabolize the drug more rapidly. This can lead to a subtherapeutic INR and an increased risk of blood clots. The nurse should teach the client to avoid St. John's wort.