Nurse 405 Exam 2 TPN and IV Fluids, Questions and answers. 2022/2023. 100% verified.

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Nurse 405 Exam 2 TPN and IV Fluids, Questions and answers. 2022/2023. 100% verified. Reason for parenteral nutrition - ✔✔Provision of nutrients through the venous system Parenteral nutriti... on is indicated when the ___ cannot function. - ✔✔Indicated for when the gut cannot function; need to use the vascular system Complications requiring parenteral nutrition - ✔✔Abd surgery, bowel obstruction, pancreatitis, severe malabsorption, malnutrition w/ increased metabolic demands Short term, cannot meet body requirements and is irritating to veins - ✔✔Peripheral Parenteral Nutrition What is included in peripheral parenteral nutrition? - ✔✔10% Dextrose, Amino Acids, Electrolytes High osmolality, requires CVAD, complete nutrition meeting total body needs - ✔✔Total Parenteral Nutrition What is included in total parenteral nutrition? - ✔✔High concentrated dextrose- 30% Amino Acids Fat emulsion- lipids Electrolytes Minerals Trace elements Vitamins Complications of TPN? - ✔✔Hyper/Hypoglycemi, Fluid overload, Infection, Electrolyte imbalances What can happen if you turn off your patient's TPN too fast? - ✔✔Hypoglycemia d/t insulin overload Why is a patient on TPN at risk for line sepsis? - ✔✔Bacteria thrive off of the sugar Nursing management for TPN - ✔✔Carefully review orders Orders re-written after daily labs Monitor BUN, Cret, electrolytes Change bag and infusion set every 24 hours Keep refrigerated until 30 mins prior to use Monitor accu-checks Administer on an in-line filter and on an infusion pump Never mix with any other drug/fluid Monitor daily weights, I&O Monitor for s/s fluid overload Monitor for infection Do NOT stop abruptly You are setting up TPN for your patient. Should you set the bag to be free falling or on a pump? - ✔✔On an infusion pump What are s/s of fluid overload? - ✔✔Cough Dyspnea Pulmonary crackles Edema A patient is receiving TPN. Which of the following interventions should the nurse include in the patient's plan of care? A. Change the tubing and in-line filter every 48 hours B. Piggy back the IV antibiotic through the same line as the TPN to prevent infection C. Monitor blood glucose every 6 hours D. administer the TPN through a large bore peripheral IV - ✔✔Answer: C Monitor blood glucose every 6 hours A patient has been on TPN for 5 days. The bag is due to be changed at 2100. The pharmacy informs you that the next bag will not be ready until 2300. Which action by the nurse would be most appropriate? A. Slow the rate of infusion to ensure the bag does not run out prior to 2300 B. Discard the current bag at 2100 and flush line C. Continue the current bag at the prescribed rate until it runs out. D. Stop the TPN at 2100 and hang dextrose 10% until the next bag is ready. - ✔✔Answer: D Stop TPN at 2100 and hang dextrose 10% until next bag is ready Which of the following are NOT included in a bag of TPN? A. Albumin B. Dextrose C. Lipids D. Vitamins E. Electrolytes - ✔✔Answer: A Albumin A patient is receiving TPN. Which of the following assessments would be of greatest concern to the nurse? A. Temperature of 38.3 degrees Celsius B. A blood glucose of 200 mg/dL C. A serum potassium of 3.4 mEq/L D. Intake is 500 mL greater than output for the past 24 hours - ✔✔A. Temp of 38.3 degrees If you hung a bag of TPN at 1600, when do you have to change it? - ✔✔At 1600 the next day, every 24 hours Purpose of IV therapy - ✔✔Replace fluid and bytes Administer medications Administer blood products Access for emergency Methods of administering medications IV - ✔✔Continuous drip Intermittent piggyback IV Push (IV Lasix) Watering moving across membrane from LESSER concentration of solutes to GREATER concentration of solutes - ✔✔Osmosis Solute concentration = plasma Given to increase extracellular fluid volume d/t blood loss, surgery, dehydration, fluid loss- that has been extracellularly - ✔✔Isotonic Solution What IV fluids are isotonic? - ✔✔0.9 Saline [Show More]

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