Author Question: The nurse is caring for a patient with severe burns who will begin receiving total parenteral ... (Read 19 times)

future617RT · **on:** Jul 23, 2018

The nurse is caring for a patient with severe burns who will begin receiving total parenteral nutrition (TPN). The patient asks why TPN is necessary. The nurse explains that TPN is used for which reason?

a. To minimize pulmonary complications
b. To prevent hyperglycemia and fluid overload
c. To promote wound healing and maintain cell integrity
d. To restore fluid and electrolyte imbalance

Question 2

The nurse is caring for a patient who is receiving total parenteral nutrition (TPN) and notes that the patient becomes dyspneic when transferring from the bed to a chair. The nurse auscultates rales in both lungs. Which action will the nurse take next?

a. Ask the patient to perform the Valsalva maneuver.
b. Decrease the TPN rate and request an order for a diuretic medication.
c. Obtain an order for a chest radiograph and an antibiotic.
d. Stop the TPN and request an order for intravenous isotonic dextrose.

jaykayy05 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
TPN is indicated for patients with severe burns who are in negative nitrogen balance. TPN enhances wound healing and provides the nutrients necessary to prevent cellular catabolism. While some pulmonary complications, such as aspiration pneumonia, do not occur with TPN, there is a risk of air embolism. Hyperglycemia and fluid overload may occur.

Answer to Question 2

ANS: B
The patient who is being treated with TPN and has dyspnea and rales is experiencing fluid overload. The nurse should slow the rate of the TPN and request an order for a diuretic. Patients perform the Valsalva maneuver during bag changes to help prevent pulmonary emboli. Patients receiving TPN are not necessarily at risk for aspiration pneumonia. Intravenous isotonic dextrose is given after sudden interruption of TPN to prevent hypoglycemia.