A nurse is caring for a client who is receiving total parenteral nutrition (TPN) via a multi-lumen central venous catheter. Which of the following interventions should the nurse implement? (Select all that apply.)
- Change the TPN administration set and filter every 24 hours.Cevap
- BAdminister prescribed intravenous medications through the TPN Y-site port.
- Monitor capillary blood glucose levels every 4 to 6 hours.Cevap
- DIncrease the infusion rate to catch up if the volume falls behind schedule.
- Hang a bag of 10% dextrose in water (D10W) if the TPN solution runs out and a replacement is delayed.Cevap
Cevap
The correct interventions are to change the administration set and filter every 24 hours, monitor capillary blood glucose every 4 to 6 hours, and hang 10% dextrose in water if the TPN is abruptly delayed.
Total parenteral nutrition (TPN) requires meticulous nursing care to prevent complications. Because the solution is an excellent medium for bacterial growth, the tubing and filter must be replaced every 24 hours. The high dextrose concentration requires routine blood glucose checks (usually every 4-6 hours) to monitor for hyperglycemia. Furthermore, if the TPN infusion is suddenly interrupted, the client's high endogenous insulin levels can cause severe rebound hypoglycemia, which is prevented by substituting a 10% dextrose in water (D10W) solution at the same flow rate.
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Safe Administration of Total Parenteral Nutrition (TPN)