Deck 14: Parenteral Nutrition

Question 1

A faculty member is evaluating the student's performance when hanging a bag of Total Parenteral Nutrition.Which step indicates the student has completed the third check for accuracy?

A) Checks the bag label with the medication record at the bedside.
B) Reviews the chart to determine if the order has been entered in the system.
C) Verifies that the bag of TPN is the same that is on the medication record.
D) Reviews information on bag of TPN with pharmacist when delivered.

Answer 1

Checks the bag label with the medication record at the bedside.

Question 2

The nurse delegates some care activities to nursing assistive personnel (NAP).What action by the NAP requires immediate intervention by the registered nurse?

A) Performs fingerstick blood glucose monitoring and records results.
B) Reports shortness of breath or headaches right away.
C) Turns the alarming IV pump off and calls for the nurse.
D) Informs the nurse promptly of any changes in vital signs.

Answer 2

Turns the alarming IV pump off and calls for the nurse.

Question 3

The faculty member describes conditions that indicate a need for parenteral nutrition to nursing students.Which conditions does the faculty member include? (Select all that apply.)

A) Abdominal trauma
B) Severe pancreatitis
C) Short-term bowel rest
D) Poor appetite with malnutrition
E) Serious malabsorption

Answer 3

Abdominal trauma
Severe pancreatitis
Serious malabsorption

Question 4

A patient is receiving parenteral nutrition through a multi-lumen central venous catheter.What intervention is most important related to this patient's situation?

A) Verify patient using two unique identifiers.
B) Label each line of the tubing carefully.
C) Wipe the end port of the tubing with alcohol.
D) Check solution for particulates or discoloration.

Question 5

A nursing student is teaching a patient about lab testing that will be done frequently while the patient is on parenteral nutrition.Which statement by the student requires the registered nurse to intervene?

A) "Your copper and zinc levels may change rapidly."
B) "We will check your protein levels about weekly."
C) "The staff will check your blood glucose frequently at first."
D) "Your white blood cell count can help us assess for infection."

Question 6

The nurse is evaluating goals for a patient who has been on home parenteral nutrition for a month.What finding indicates that a priority goal has been met?

A) Weight has increased by 5 pounds (2.26 kg).
B) Patient describes correct care of system.
C) Exit site is free of redness, tenderness, or drainage.
D) Fingerstick glucose readings are out of range only 20% of the time.

Question 7

The nursing assistive personnel (NAP) reports that a patient receiving parenteral nutrition via a central line is coughing and short of breath.Which action by the nurse is the priority?

A) Clamp the IV tubing.
B) Call for a chest x-ray.
C) Notify the provider.
D) Check a bedside glucose.

Question 8

A nurse is preparing to discharge a patient who is going home on Total Peripheral Nutrition (TPN).What action by the nurse is most helpful in ensuring positive outcomes for the patient?

A) Refer the patient to a home nutrition therapy team.
B) Order three months' worth of supplies for the patient.
C) Assess the patient's psychological response to the therapy.
D) Determine if any family members are willing to help.

Question 9

A patient has been receiving parenteral nutrition (PN) via a central line that has now occluded.The patient also has a midline catheter.What modification of the PN does the nurse ensure prior to switching the PN to the midline catheter?

A) Holding the lipid infusion
B) Ensuring osmolality is less than 900 mOsm
C) Doubling the insulin concentration
D) Cutting the total fluid volume to 1500 mL

Question 10

The lab calls the charge nurse and reports a blood glucose reading of 220 mg/dL for a patient on parenteral nutrition via a central line.What action does the charge nurse take first?

A) Notify the provider and request sliding scale insulin.
B) Inform the patient's nurse about the need for an insulin drip.
C) Asks the pharmacy to dilute the glucose concentration.
D) Determine if the nurse drawing the blood follow protocol.

Question 11

A provider has listed orders for Peripheral Parenteral Nutrition with lipids for four patients.Which patient will the nurse clarify the orders about?

A) 80-year-old on dialysis
B) 18-year-old with anorexia nervosa
C) 75-year-old with a bowel obstruction
D) 35-year-old undergoing chemotherapy