A child is receiving total parenteral nutrition (TPN; ...

[codyclark]

A child is receiving total parenteral nutrition (TPN; hyperalimentation). At the end of 8 hours, the nurse observes the solution and notes that 200 ml/8 hr is being infused rather than the ordered amount of 300 ml/8 hr.
 
  The nurse should adjust the rate so that how much will infuse during the next 8 hours?
  a. 200 ml
  b. 300 ml
  c. 350 ml
  d. 400 ml

Question 2

The nurse must suction a child with a tracheostomy. Interventions should include:
 
  a. encouraging child to cough to raise the secretions before suctioning.
  b. selecting a catheter with diameter three fourths as large as the diameter of the tracheostomy tube.
  c. ensuring each pass of the suction catheter should take no longer than 5 seconds.
  d. allowing child to rest after every five times the suction catheter is passed.

[nikmaaacs]

Answer to Question 1

ANS: B
The TPN infusion rate should not be increased or decreased without the practitioner being informed because alterations in rate can cause hyperglycemia or hypoglycemia. Any changes from the prescribed flow rate may lead to hyperglycemia or hypoglycemia.

Answer to Question 2

ANS: C
Suctioning should require no longer than 5 seconds per pass. Otherwise, the airway may be occluded for too long. If the child is able to cough up secretions, suctioning may not be indicated. The catheter should have a diameter one half the size of the tracheostomy tube. If it is too large, it might block the child's airway. The child is allowed to rest for 30 to 60 seconds after each aspiration to allow oxygen tension to return to normal. Then the process is repeated until the trachea is clear.

[codyclark]

TYSM

[kishoreddi]

Excellent