Nokea
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.
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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.
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.
The nurse is administering a parenteral nutrition infusion to a patient. The nurse will implement which measures to prevent infection? (Select all that apply.)
- A. Change the intravenous tubing set every 72 hours.
- B. Change the intravenous tubing set every time a new bag is added to the infusion.
- C. Use a 1.2-micron filter with each tubing set.
- D. Monitor the patient's temperature every shift during the infusion.
- E. Report any increase in the patient's temperature over 100?°F.
Correct Answer: D,E
Rationale: To prevent infection during parenteral nutrition infusion, the nurse should monitor the patient's temperature every shift and report any increase over 100?°F. Changing the tubing every 24 hours (not 72 hours or with each new bag) and using a 0.22-micron filter (not 1.2-micron) are standard practices, but the options provided are incorrect for infection prevention.
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%.
During the night shift, a patient's total parenteral nutrition (TPN) infusion ran out, and the nurse discovered that there was no TPN solution on hand to continue the infusion. The pharmacy is closed and will not reopen for 5 hours. The nurse will have to implement measures to prevent which consequence of abruptly discontinuing TPN infusions?
- A. Dehydration
- B. Hyperglycemia
- C. Dumping syndrome
- D. Rebound hypoglycemia
Correct Answer: D
Rationale: Rebound hypoglycemia may occur if TPN is discontinued abruptly. It may be prevented by infusion of 5% to 10% glucose in situations in which TPN must be stopped abruptly. The other options are incorrect.