Question 1

Candidates for TPN are patients who ____.

Accepted Answer

TPN is indicated for patients who are unable to use their GI tracts for long periods, typically greater than 10 days. This may include patients who have had major surgery, bowel obstruction, severe Crohn's disease, or other conditions that impair the digestive system for extended periods of time. While the other options may also be indications for TPN, A is the most accurate and specific answer.

Question 2

Redness, swelling, and tenderness at the insertion site is described as ____.

Accepted Answer

Redness, swelling, and tenderness at the insertion site are classic signs of phlebitis, which is inflammation of a vein. A hematoma refers to a localized collection of blood outside the blood vessels, infiltration occurs when IV fluids leak into the surrounding tissue, and nerve damage would present with different symptoms.

Question 3

Traditionally, central catheters enter the circulation at the ____ vein and are threaded into the superior vena cava with the tip of the catheter lying close to the heart.

Accepted Answer

The right subclavian vein is the most common site for central venous access because of its direct path to the superior vena cava and its larger size compared to other veins in the area. This allows for easier insertion and better blood flow.

Question 4

To prevent phlebitis, the osmolarity of parenteral solutions used for PPN is generally kept below ____ milliosmoles per liter.

Accepted Answer

The answer of To prevent phlebitis, the osmolarity of parenteral...

Question 5

Parenteral nutrition would most likely be contraindicated in which condition?

Accepted Answer

Parenteral nutrition involves delivering nutrients directly into the bloodstream, bypassing the gastrointestinal (GI) tract. It is typically used when the GI tract is not functional or when a patient cannot consume food orally or enterally. However, in cases of severe hyperglycemia, parenteral nutrition can exacerbate the condition due to the high glucose content in the nutrition solution, making it contraindicated. Conditions like paralytic ileus, GI bleeding, and intractable vomiting may actually necessitate the use of parenteral nutrition because they impair the normal function of the GI tract.

Question 6

What describes a benefit of peripheral insertion of a central catheter?

Accepted Answer

The answer of What describes a benefit of peripheral insertion...

Question 7

The large-diameter central veins are located near the ____.

Accepted Answer

The large-diameter central veins carry deoxygenated blood from the extremities back to the heart, which then pumps the blood to the lungs for reoxygenation. Therefore, the central veins are located near the heart.

Question 8

The protein in a TPN solution is primarily in the form of ____.

Accepted Answer

The protein in a TPN solution is typically in the form of amino acids. This is because amino acids are more readily absorbed and utilized by the body than intact proteins or protein hydrolysates. Short-chain fatty acids are not a source of protein.

Question 9

Which form of glucose is available in parenteral solutions?

Accepted Answer

Dextrose is the form of glucose that is commonly available in parenteral solutions. This is because it is the simplest and most easily metabolized form of glucose, and can be quickly and easily absorbed by the body. In contrast, fructose, lactose, and galactose are all more complex forms of sugar that require additional processing and metabolism by the body in order to be usable.

Question 10

Delivery of nutrient solutions directly into the vein is called ____.

Accepted Answer

Delivery of nutrient solutions directly into the vein is called parenteral nutrition. A is incorrect because standard nutrition is not a term used in nutrition. B is incorrect because enteral nutrition involves the delivery of nutrients through the digestive system, such as through a feeding tube or oral supplements. D is incorrect because tube feeding specifically refers to the delivery of nutrients through a tube placed into the stomach or intestines, which is a form of enteral nutrition.

Question 11

Osmolality is usually derived by using ____.

Accepted Answer

Osmolality is usually measured by using an instrument called an osmometer. This instrument measures the concentration of particles in a solution, which is used to determine the osmolality. Equations and weights of nutrients and electrolytes can be used to calculate osmolality, but using an osmometer is more direct and accurate. A spectrometer is used to measure the absorption or transmission of light by a sample, and is not used to measure osmolality.

Question 12

Osmolarity refers to  milliosmoles of ions and molecules per ____.

Accepted Answer

Osmolarity measures the concentration of solutes in a solution in terms of milliosmoles of particles per liter of solution. It is denoted as mOsm/L.

Question 13

The use of PPN is not possible in a patient with ____.

Accepted Answer

PPN requires access to peripheral veins, therefore if a patient has weak peripheral veins, the use of PPN may not be possible.

Question 14

Dextrose concentrations of ____ percent or lower can be used for PPN solutions.

Accepted Answer

Dextrose concentrations of 10% or lower can be used for PPN solutions, as higher concentrations may cause phlebitis or other complications. Choices B, C, and D are not correct as dextrose concentrations at these levels are too high for safe use in PPN solutions.

Question 15

What is an advantage of TPN?

Accepted Answer

TPN allows for precise and individualized nutrient concentrations, which can be adjusted as needed to meet the patient's specific needs. This is an advantage over regular IV fluids, which are typically limited in their nutrient content.

Question 16

PPN is most often used in patients who require nutrition support for less than ____.

Accepted Answer

PPN is a short-term nutrition support for patients who need it for less than two weeks. If a patient requires nutrition support for a longer period, the use of central venous access devices (CVADs) and total parenteral nutrition (TPN) would be recommended.

Question 17

A client receiving greater than 2000 kcalories per day via parenteral nutrition should ____.

Accepted Answer

Clients receiving greater than 2000 kcalories per day via parenteral nutrition should have it administered through the central venous route to reduce the risk of complications such as phlebitis or thrombosis. Peripheral veins are not suitable for high osmolarity solutions, and bolus administration may cause rapid changes in fluid and electrolyte balance. Dextrose and amino acids are not sufficient for meeting the client's total caloric needs.

Question 18

How much energy does dextrose provide?

Accepted Answer

Dextrose, also known as glucose, provides 3.4 kcal per gram of energy.

Question 19

Joan Sussman is in her second trimester of pregnancy and has experienced hyperemesis gravidarum (excessive vomiting, possible fluid and electrolyte imbalances)for 14 days. At this point, she is a candidate for ____.

Accepted Answer

Joan's prolonged hyperemesis gravidarum puts her at risk for malnutrition and dehydration, and a tube feeding or a clear liquid diet may not provide adequate nutrition. Peripheral parenteral nutrition may also not provide the necessary nutrients and may have a high risk of infection. Total parenteral nutrition, which involves intravenous administration of nutrients, is the best choice for Joan in this situation to ensure she receives the necessary nutrients for both her and her growing baby's health.

Question 20

The movement of water across biological membranes is known as ____.

Accepted Answer

The movement of water across biological membranes is specifically known as osmosis. Diffusion, absorption, and peripheral transport may also occur across biological membranes, but these terms do not refer specifically to the movement of water.

Quiz 21: Parenteral Nutrition Support