Examkin

Günün Sorusu

Her gün yeni bir NCLEX-RN sorusu — alışkanlık kazan.

A client is receiving total parenteral nutrition (TPN) through a single-lumen peripherally inserted central catheter (PICC). The healthcare provider prescribes a scheduled dose of intravenous (IV) ciprofloxacin to treat a systemic infection. Which of the following actions is the most appropriate for the nurse to take?

  1. Insert a new peripheral venous catheter to administer the prescribed antibiotic.Cevap
  2. B
    Attach the antibiotic tubing to the Y-site port closest to the central catheter insertion site.
  3. C
    Suspend the parenteral nutrition temporarily, flush the line with normal saline, give the antibiotic, and resume the nutrition.
  4. D
    Increase the infusion rate of the parenteral nutrition to finish the current volume before the antibiotic is due.

Cevap

The most appropriate action is to establish a separate, new peripheral venous access device to administer the antibiotic, as the single-lumen PICC must remain dedicated solely to the total parenteral nutrition.
Total parenteral nutrition (TPN) solutions are complex formulations with a very high risk for physical and chemical incompatibilities when combined with other drugs. Additionally, because of its high dextrose and lipid content, accessing the line frequently heavily increases the risk of a central line-associated bloodstream infection. Therefore, evidence-based best practice dictates that a single-lumen catheter used for TPN must remain exclusively dedicated to the nutrition infusion. The nurse must establish a separate peripheral venous access site to administer the intravenous antibiotic safely.

Adım Adım Çözüm

1
Identify the client's current intravenous access and continuous infusions.
The client has a single-lumen PICC that is currently infusing TPN.
Determines the available resources for safe medication administration.
2
Analyze the principles of safe total parenteral nutrition (TPN) administration.
TPN requires a strictly dedicated line due to high incompatibility risks, infection risks, and the need for an uninterrupted flow to maintain glycemic stability.
Guides the clinical decision on whether the existing central line can be safely utilized.
3
Determine the necessary nursing intervention to administer the new medication safely.
A new, separate vascular access (such as a peripheral IV) must be initiated.
Ensures the prescribed antibiotic is administered on time without compromising the safety and efficacy of the parenteral nutrition therapy.

Anahtar Kavram

Total Parenteral Nutrition (TPN) Administration Safety and Dedicated Vascular Access
Sorunun tamamını ve çözümünü görTam deneme testi çöz