Nokea
A woman has been receiving both radiation and chemotherapy for her cancer. Lately, she has developed anorexia caused by the treatments, so she needs short-term nutrition supplementation. The nurse anticipates that the physician will initiate which therapy?
- A. Central total parenteral nutrition
- B. Peripheral parenteral nutrition
- C. Oral nutritional supplements with meals
- D. Nasogastric enteral supplementation
Correct Answer: B
Rationale: Peripheral parenteral nutrition is indicated for anorexia caused by radiation or cancer chemotherapy. Total parenteral nutrition is indicated for more long-term use. The other options are incorrect.
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When monitoring a patient who has been receiving peripheral parenteral nutrition for more than 3 weeks, the nurse will watch for which potential complication?
- A. Diarrhea
- B. Phlebitis
- C. Hypernatremia
- D. Hypoglycemia
Correct Answer: B
Rationale: The long-term administration of nutritional supplements via a peripheral vein may lead to phlebitis and, possibly, the loss of a limb.
A patient with type 2 diabetes will be receiving a nasogastric tube feeding for a few days. The nurse expects which type of formula to be used?
- A. Jevity
- B. Ensure Plus
- C. Glucerna
- D. Polycose
Correct Answer: C
Rationale: Glucerna is a formulation designed for use in patients with impaired glucose tolerance (e.g., diabetic patients). The other options are not designed for patients with diabetes.
An older adult patient needs to receive an enteral supplement to improve her overall nutritional status. When considering enteral supplements, the nurse notes that which formulation provides complex nutrients?
- A. Ensure Plus
- B. Moducal
- C. ProMod
- D. Microlipid
Correct Answer: A
Rationale: Ensure Plus is a polymeric formulation that contains complex nutrients, including proteins, carbohydrates, and fats. Moducal provides carbohydrates only; ProMod is a protein formulation, and Microlipid supplies only fats.
A patient has been receiving total parenteral nutrition. Upon assessment, the nurse notes these assessment findings: blood pressure 160/98 mm Hg (elevated from previous readings); pulse rate 110 beats/min and weak; pitting edema on both ankles; and new-onset confusion. The nurse suspects that the patient is experiencing which condition?
- A. Infection
- B. Hypoglycemia
- C. Hyperglycemia
- D. Fluid overload
Correct Answer: D
Rationale: Fluid overload may occur with parenteral nutrition. It is manifested by weak pulse, hypertension, tachycardia, confusion, decreased urine output, and pitting edema.
The peripheral parenteral nutrition bag that has been infusing into the patient is empty, and the nurse realizes that the next bag is not ready. The nurse should immediately hang which of these intravenous solutions until the new bag arrives?
- A. 10% dextrose in water
- B. 20% dextrose in water
- C. 0.9% sodium chloride
- D. Lactated Ringer's solution
Correct Answer: A
Rationale: If intravenous parenteral nutrition is discontinued abruptly, rebound hypoglycemia may occur. This can be prevented with infusion of 5% to 10% glucose until the parenteral nutrition infusion is ready. For peripheral infusions, the dextrose must not be more than 10%.