Question 1

Which type of parenteral nutrition provided at night allows patients to participate in routine activities during the day?

Accepted Answer

Cyclic parenteral nutrition is delivered over 8-16 hours at night, allowing patients to participate in routine activities during the day. Continuous parenteral nutrition is delivered over 24 hours a day and requires the patient to be connected to the infusion device all day, which may limit activity. Peripheral parenteral nutrition is delivered through a smaller vein and is typically used for short-term nutrition support when central access is not available. Piggyback parenteral nutrition is administered in addition to other infusion therapies and is not a standalone nutrition support.

Question 2

Before parenteral nutrition is discontinued, oral intake, tube feeding, or a combination of both should provide at least _____ percent of the estimated energy needs.

Accepted Answer

Before discontinuing parenteral nutrition, oral intake, tube feeding, or a combination of both should provide at least 60 to 75 percent of the estimated energy needs. This ensures that the patient's nutritional needs are being met and they are no longer dependent on parenteral nutrition to maintain their health. Discontinuing parenteral nutrition too early or without proper transitioning can lead to malnutrition and other health complications.

Question 3

Which statement is true of Terri's Law?

Accepted Answer

Terri's Law was a Florida law that allowed the governor to intervene in the Terri Schiavo case to continue life-sustaining treatment, despite her husband's wishes to withdraw it. The law was later found unconstitutional, as it was deemed to violate the separation of powers.

Question 4

A patient should be fully informed of a treatment's benefits and risks in a fair and honest manner. If the patient agrees to the proposed treatment, it is referred to as ____.

Accepted Answer

This statement refers to the concept of informed consent, which is the process of fully disclosing all relevant information about a treatment to a patient so that they can make an informed decision about whether or not to undergo the treatment. Informed consent is based on the principle of respect for autonomy, which holds that individuals have a right to make decisions about their own healthcare. Beneficence and distributive justice are also important ethical principles in healthcare, but they do not directly relate to the concept of informed consent.

Question 5

When providers consider whether provision of health care for one patient would unfairly limit the care of other patients, ____ is being considered.

Accepted Answer

Distributive justice is concerned with the fair distribution of societal resources, including health care. Providers must consider whether providing care to one patient will unfairly limit the care available to other patients. Autonomy is the right of the patient to make decisions about their own health care, while informed consent is obtaining the patient's permission before providing treatment. Beneficence is the principle of doing what is in the best interest of the patient. While all of these principles are important, only distributive justice directly relates to the consideration of limited resources in providing health care.

Question 6

The enteral formula used for home nutrition is most often influenced by cost and ____.

Accepted Answer

The enteral formula used for home nutrition is most often influenced by cost and availability, as these factors can determine which formulas are accessible and affordable for patients to use regularly. Taste, efficiency of administration, and appearance may also play a role, but are typically of secondary importance compared to cost and availability.

Question 7

A 12-year-old patient is being weaned off of total parenteral nutrition. In addition to total parenteral nutrition, he is on a soft diet. The patient is 5 ft 2 in. tall and weighs 110 lb. His energy needs are estimated to be approximately 2100 kcal/day. His kcalorie count reveals he is consuming 1700 kcal/day. Which intervention is appropriate at this time?

Accepted Answer

The answer of A 12-year-old patient is being weaned off...

Question 8

Shawna is on home total parenteral nutrition and is having trouble adjusting to the changes in her life. Which organization does the text recommend as a good source of support and information for her?

Accepted Answer

The Oley Foundation is a national organization that provides support and information specifically for individuals on home parenteral and enteral nutrition. They have resources for coping with the changes in lifestyle that come with being on TPN, and offer a variety of support services. P-CAN, Livestrong, and ACS are all organizations focused on cancer support, and while they may have some resources that could be helpful, they are not specifically geared towards individuals on TPN.

Question 9

One of the greatest concerns of patients who use home nutrition support is the ____.

Accepted Answer

Patients often feel socially isolated because they cannot participate in meals with friends and family, which is a significant concern for those on home nutrition support.

Question 10

Liver enzymes should be monitored ____ during parenteral support.

Accepted Answer

Liver enzymes should be monitored weekly during parenteral support to ensure liver function remains stable and to detect any potential complications early.

Question 11

How often should the fluid intake and output of a patient on total parenteral nutrition be checked?

Accepted Answer

The answer of How often should the fluid intake and...

Question 12

Refeeding syndrome is characterized by fluid and electrolyte imbalances and ____.

Accepted Answer

Refeeding syndrome is characterized by fluid and electrolyte imbalances and hyperglycemia. This occurs when feeding is started after a period of malnutrition or starvation, leading to insulin secretion and subsequent shifts in electrolytes and glucose metabolism.

Question 13

Which condition describes a catheter-related complication of parenteral nutrition?

Accepted Answer

Catheter-related complications of parenteral nutrition can include air embolism, catheter dislodgement, catheter blockages, and infections at the catheter site. Air embolism can occur if air enters the catheter during insertion or if the catheter becomes disconnected. This can result in serious cardiovascular and respiratory complications. Refeeding syndrome is a metabolic complication that can occur when a malnourished individual receives too much nutrition too quickly. Gallbladder disease and nutrient deficiencies may be complications of long-term parenteral nutrition, but they are not specifically related to catheter placement.

Question 14

What best describes the role of the nurse on the nutrition support team?

Accepted Answer

The role of the nurse on the nutrition support team is to perform direct patient care, which may include monitoring the patient's tolerance to nutrition interventions, assessing and managing feeding tube placement and functioning, and educating patients and their families on proper nutrition support techniques. The other options listed may fall under the scope of practice of other members of the nutrition support team, such as a registered dietitian or a pharmacist.

Question 15

The health care team has just ordered total parenteral nutrition for Mr. Calabria. He is a 58-year-old man who is suffering from intractable diarrhea. Before Mr. Calabria starts TPN, what procedure should be performed?

Accepted Answer

Before starting TPN, an X-ray should be performed to confirm catheter placement to ensure that TPN is delivered into the central venous system and not into the surrounding tissues, which can cause complications such as infection or tissue damage. Body mass index assessment, calcium balance, and hand grip strength may all be useful measures for monitoring Mr. Calabria's nutritional status and progress during TPN, but they are not necessary before starting the treatment.

Question 16

A female patient who is on long-term parenteral nutrition is at risk for ____.

Accepted Answer

Long-term parenteral nutrition has been linked to an increased risk of developing osteoporosis due to inadequate levels of physical activity and reduced bone turnover associated with prolonged immobilization.

Question 17

In which situation would home total parenteral nutrition be an appropriate means for maintaining adequate nutrition status?

Accepted Answer

Home total parenteral nutrition would be appropriate for an individual with chronic intestinal obstruction as this condition can prevent adequate absorption of nutrients through the gastrointestinal tract. Dysphagia and neurological impairment affecting the esophagus would require alternative methods to manage nutrition such as enteral nutrition or modified diets. Head and neck cancer may require interventions such as surgery or radiation but may not necessarily require total parenteral nutrition.

Question 18

The potential good that can come from a proposed treatment is referred to as ____.

Accepted Answer

The potential good that can come from a proposed treatment is referred to as beneficence, which is one of the ethical principles in healthcare. Autonomy refers to the patient's right to make their own decisions about their healthcare. Informed consent refers to the process of fully informing patients about their treatment options and obtaining their consent before a procedure. Distributive justice pertains to the fair and equitable distribution of healthcare resources. However, none of these concepts relate to the potential good that can come from a proposed treatment.

Question 19

When refrigerated, ready-made parenteral solutions may be stable for ____.

Accepted Answer

The answer of When refrigerated, ready-made parenteral solutions may be...

Question 20

A patient on total parenteral nutrition for longer than a few ____ is at risk for "sludge" buildup in the gallbladder and gallstone formation.

Accepted Answer

Total parenteral nutrition (TPN) for longer than a few weeks can lead to a lack of stimulation of the gallbladder, causing bile to stagnate and form "sludge," which can lead to gallstone formation.

Quiz 21: Parenteral Nutrition Support