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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.
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A patient with a partial bowel obstruction will be given a 1-week course of enteral tube feeding via a nasogastric tube. Which formulation is appropriate for this patient?
- A. An elemental formulation
- B. A polymeric formulation
- C. A formulation for impaired glucose tolerance
- D. A modular formulation that contains carbohydrates
Correct Answer: A
Rationale: Elemental formulations are enteral supplements that require minimal digestion and are indicated for patients with pancreatitis, partial bowel obstruction, irritable bowel disease, and other problems. The other options are incorrect.
A patient is receiving a nutritional supplement via an enteral feeding tube. The nurse will monitor for which common adverse effect?
- A. Diarrhea
- B. Constipation
- C. Fluid overload
- D. Heartburn
Correct Answer: A
Rationale: Diarrhea is the most common result of the gastrointestinal intolerance that occurs with nutritional supplementation.
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%.
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.
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.