Author Question: The patient is having at least 75 of his nutritional needs met by enteral feeding, so the physician ... (Read 172 times)

cdr_15 · **on:** Jul 23, 2018

The patient is having at least 75 of his nutritional needs met by enteral feeding, so the physician has ordered the PN to be discontinued. However, the nurse notices that the PN infusion has fallen behind. The nurse should

a. Increase the rate to get the volume caught up before discon-tinuing.
b. Stop the infusion and hang a normal saline drip in place.
c. Taper the PN infusion gradually.
d. Hang 5 dextrose if the PN runs out.

Question 2

The nurse is caring for a patient who will be receiving PN. To reduce the risk of developing sep-sis, the nurse

a. Takes down a running bag of TPN after 36 hours.
b. Runs lipids for no longer than 24 hours.
c. Wears a sterile mask when changing the CVC dressing.
d. Wears clean gloves when changing the CVC dressing.

tranoy · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
Sudden discontinuation of PN can cause hypoglycemia. PN must be tapered off. Usually, 10 dextrose is infused when PN solution is suddenly discontinued. The same is true if the PN runs out. Too rapid administration of hypertonic dextrose (PN) can result in an osmotic diuresis and dehydration. If an infusion falls behind schedule, the nurse should not increase the rate in an at-tempt to catch up.

Answer to Question 2

ANS: C
During CVC dressing changes, always use a sterile mask and gloves, and assess insertion sites for signs and symptoms of infection. To avoid infection, change the TPN infusion tubing every 24 hours, and do not hang a single container of PN for longer than 24 hours or lipids longer than 12 hours.