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Chapter 34: Problem 44

For a client that is receiving total parenteral nutrition (TPN), which assessment data would be most indicative of infection within 48 hours of initiation of therapy? A. Confusion B. Diaphoresis C. Heart rate 120 D. Temperature of \(101^{\circ} \mathrm{Fahrenheit.}\)

Short Answer

Expert verified
A temperature of \(101^\circ \text{Fahrenheit}\) is the most indicative of infection within 48 hours of initiation of therapy.

Step by step solution

01

Identify Common Signs of Infection

The first step in determining the most indicative sign of infection is to identify common physiological indicators associated with an infection. These generally include elevated body temperature, increased heart rate, changes in mental status, and sometimes increased sweating.
02

Compare Options with Infection Indicators

Match the provided options with the known common signs of infection. Confusion can occur with infection but is a less specific sign compared to a fever. Diaphoresis (sweating) can occur but is also less specific. An increased heart rate could signify an infection but is a bodily response to various conditions. An elevated temperature (fever) is a primary, more definitive sign of infection.
03

Choose the Most Specific Indicator

Select the option that most specifically relates to an infection. A temperature of 101 degrees Fahrenheit is a physiological response most directly indicative of an infection, as it is a common immunological response to the presence of pathogens.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Total Parenteral Nutrition
Total parenteral nutrition (TPN) is a life-saving therapy for patients who cannot eat or absorb nutrients through their gastrointestinal tract. Understanding TPN is critical for both nursing students preparing for the NCLEX-RN Examination and for the clinicians overseeing patient care.

TPN is administered intravenously, bypassing the digestive system entirely. It provides all the necessary nutrients such as carbohydrates, proteins, fats, vitamins, and minerals directly into the bloodstream. Given its invasive nature, TPN is linked to a higher risk of infection, particularly if sterile techniques are not meticulously followed. It is paramount to monitor for any signs of infection in patients receiving TPN, especially within the first 48 hours when they are most vulnerable.
Signs of Infection
Infection can present in various forms, and healthcare professionals must be astute observers to detect it early. The signs of infection include a constellation of symptoms known as systemic inflammatory response syndrome (SIRS). This response can manifest as fever, chills, an increased heart rate, or tachycardia, and it may also lead to changes in blood pressure and mental status.

Monitoring for Specific Signs

Part of a nurse's role is vigilant monitoring for these specific indicators. Other potential signs could be redness, swelling, or pain at the TPN catheter insertion site. While some signs like confusion and sweating (diaphoresis) may be associated with infection, they are less specific and can result from a variety of different causes, which makes them less reliable for diagnosing an infection.
Fever as an Infection Indicator
Fever is one of the body's natural responses to infection, serving as a primary indicator that an immune response has been activated. This response raises the core body temperature to create an environment that is less hospitable to pathogens. When considering TPN-related infections, a fever, specifically one that鈥檚 higher than 101掳贵, is a crucial sign.

Understanding Fever Response

A fever can activate the immune system to enhance the efficiency of white blood cells in combating infection. In a clinical setting, a sustained or rising fever can signify an ongoing infection. For healthcare providers overseeing patients on TPN, diligent observation for fever is a key aspect of infection control protocols and subsequent intervention strategies.

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Most popular questions from this chapter

The nurse is assessing a newborn. A sudden noise causes the newborn infant to extend and then flex the arms and fingers. The nurse would document this as a positive: A. Moro reflex B. Gag reflex C. Babinski reflex D. Tonic neck reflex

A female client is being taught self-breast exam. Which information should the nurse include in the instructions? A. The nipple area should be avoided in palpating the breast. B. Breast exams are best performed immediately prior to menses. C. Self-breast exams are performed in the upright and supine positions. D. Should a lump be found, make an appointment for a professional examination if it hasn鈥檛 disappeared in a month.

A newborn with a diaphragmatic hernia and respiratory distress is admitted to the pediatric unit. The admitting physician writes the following orders: \- Position in semi- to high Fowlers \- Position on affected side. \- Diet for age. \- NG tube to suction Which order should the nurse question in the preoperative period? A. Position in semi- to high Fowlers B. Position on affected side. C. Diet for age. D. NG tube to suction

A client is admitted for pneumonia. The nurse instructs the client to change positions every two hours. The client asks the nurse why this is important. The nurse explains that turning: A. prevents Actelectasis of the lungs. B. promotes drainage from the lung lobes by gravity. C. changes the portion of the lung that is splinted by the bed. D. keeps uninvolved portions of the lungs from becoming infected.

While being fed, a newly admitted infant with tetralogy of Fallot suddenly becomes very cyanotic and shows severe cardiac distress. Physician orders have not been written. Which action should the nurse take? A. Administer oxygen B. Administer morphine sulfate C. Place the child in knee chest position D. Place the child in high fowler's position
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