Deck 32: Parenteral Nutrition

Question 1

The patient is in the hospital with a diagnosis of intestinal failure.What type of nutrition would this patient require?

A) Enteral
B) Parenteral
C) A combination of enteral and parenteral
D) Oral

Answer 1

Parenteral

Question 2

The nurse is caring for a patient who is receiving parenteral nutrition (PN).The nurse realizes that PN is associated with: (Select all that apply.)

A) Decreased mortality
B) Bloodstream infection
C) Pneumothorax
D) Decreased length of stay

Answer 2

Bloodstream infection
Pneumothorax

Question 3

The patient has been receiving a solution of 5% dextrose intravenously but will require long-term therapy with dextrose solutions greater than 10%.What will be required to provide this nutrition to the patient?

A) A second intravenous line
B) An enteral feeding tube
C) A central venous access device
D) An increased flow rate in the current line

Answer 3

A central venous access device

Question 4

The patient is to receive lipid therapy and peripheral parenteral nutrition (PPN).The nurse should be sure that:

A) The IV catheter is no larger than 20 gauge
B) Triglyceride levels are drawn before therapy is started
C) The fat emulsion is changed every 24 hours
D) The fat emulsion is completed within 3 hours

Question 5

The patient had surgery 1 week earlier and has not been eating his meals and states that he has no appetite.The nurse notices that the patient has been progressively losing weight.What should the nurse do?

A) Encourage the patient to eat
B) Force feed the patient
C) Consult with the nutritional support team
D) Be aware that the patient will come around when hungry

Question 6

The essential fatty acid that cannot be made from other fats in human metabolism and therefore must be supplied is known as ______________.

Question 7

The nurse is caring for a patient who is receiving PN.As part of the patient's therapy,the patient receives routine bedside glucose monitoring.Why is this done?

A) To keep the blood glucose lower than normal since the PN is delivering glucose directly to the bloodstream
B) To keep the blood glucose slightly higher than normal to meet the needs of the increased cellular need
C) To keep the blood glucose slightly higher than normal to prevent infection or systemic sepsis
D) To keep the blood glucose in the normal range to prevent associated complications

Question 8

The patient will be going home on PN.Patient and family education should include information about the effects of home parenteral nutrition (HPN)on quality of life (QOL).Which of the following are issues identified with HPN? (Select all that apply.)

A) Depression
B) Sleep disturbances
C) Frequent urination
D) Fear of complications
E) None of above

Question 9

The nurse is aware that a sudden disruption of PN therapy may lead the client to experience:

A) Fever
B) Chest pain
C) Erythema and induration
D) Shaking and dizziness

Question 10

The nurse has been caring for a patient who has had a central venous catheter in place.The patient complains of sudden chest pain and difficulty breathing.The nurse notices the absence of breath sounds in the lower right base.The nurse notifies the physician immediately,suspecting which of the following conditions?

A) Exit site infection
B) Catheter-related sepsis
C) Pneumothorax
D) Hyperglycemia

Question 11

Examples of central venous access devices include: (Select all that apply.)

A) Peripherally inserted central catheters (PICCs)
B) Implanted infusion ports
C) Antecubital lines
D) Peripheral lines

Question 12

The nurse is caring for a patient receiving PN.In planning the patient's care for the day,the nurse focuses on which of the following? (Select all that apply.)

A) Electrolyte level
B) Weight
C) Temperature
D) Condition of insertion site
E) None of above

Question 13

_________________ is a specialized form of nutritional support given to patients who need nutrients that are given intravenously.

Question 14

When administering fat (lipid)emulsions via piggyback infusion,what should the nurse be sure to do?

A) Insert into the port closest to the drip chamber
B) Add the solution below the infusion filter
C) Add the solution above the infusion filter
D) Avoid the port nearest to the venipuncture site.

Question 15

The nurse is preparing a bag of PN solution for administration and notices a thin layer of fat droplets.What should she do?

A) Invert the bag back and forth gently to mix
B) Notify the pharmacy and request a new solution
C) Do not use the PN solution
D) Insert a needle and withdraw the fat droplets

Question 16

During an assessment for potential septicemia on a client with parenteral nutrition,the nurse is alert to:

A) Shaky, dizzy
B) Chest pain/hypotension
C) Increased thirst
D) Increased temperature

Question 17

The patient has been receiving PN but has not had any lipid emulsion therapy.The nurse notices that the patient is developing dry,scaly skin,and his wound is healing more slowly than expected.The patient is also anemic.What does the nurse suspect the patient is experiencing?

A) Excess linoleic acid
B) Omega-6 fatty acid excess
C) Essential fatty acid deficiency
D) A 3:1 nutrition admixture

Question 18

The nurse notices that the patient weighs 4 pounds more this morning than yesterday.What is the most probable cause of this weight gain?

A) Increased nutrition from the patient's parenteral infusions
B) Decreased linoleic acid intake
C) Increased fluid loss
D) Fluid retention

Question 19

For patients receiving PN,___________ provide supplemental kilocalories and prevent essential fatty acid deficiencies.

Question 20

Which measurement would a nurse expect to see for a client receiving PN?

A) Weight gain of 1 to 2 pounds per week
B) Serum calcium level of 10 mEq/L
C) Serum potassium level of 2.8 mEq/L
D) Serum glucose level of more than 200 mg/100 mL

Question 21

PPN is difficult to maintain because of frequent episodes of phlebitis in superficial arm veins and infiltrations of solutions into subcutaneous tissue.Therefore the final dextrose concentration must be no greater than _____,because the peripheral vein will sclerose at higher concentrations.

Question 22

A patient with linoleic acid deficiency is _______________ and thus at risk for infection.