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Chapter 34: Problem 517

A client is receiving Total Parenteral Nutrition (TPN). Which is a common complication of TPN for which the nurse must monitor? A. Phlebitis B. Hypoglycemia C. Electrolyte Imbalance D. Fluid Volume Deficiency The answer is \(D\). The hypertonic fluid draws water from the tissues and can lead to fluid volume deficit. Hyperglycemia may be a problem, not hypoglycemia. The physician writes TPN orders based on the client's electrolyte balance TPN is always administered by central line so phlebitis would be a minimal risk.

Short Answer

Expert verified
The nurse should monitor for Fluid Volume Deficiency.

Step by step solution

01

- Understand the Question

Identify what is being asked. A client is receiving Total Parenteral Nutrition (TPN) and we need to determine a common complication for which the nurse must monitor.
02

- Examine the Options

Review each option provided: A. Phlebitis B. Hypoglycemia C. Electrolyte Imbalance D. Fluid Volume Deficiency
03

- Consider Each Option

Evaluate the likelihood of each option: A. Phlebitis: TPN is administered via a central line so the risk is minimal. B. Hypoglycemia: Hyperglycemia is more likely due to the glucose concentration in TPN. C. Electrolyte Imbalance: Although electrolyte monitoring is required, it is not as common as other issues. D. Fluid Volume Deficiency: The hypertonic fluid in TPN can draw water from the tissues, leading to fluid volume deficit.
04

- Choose the Correct Answer

Based on the evaluation, option D. Fluid Volume Deficiency is the common complication of TPN for which a nurse should monitor.

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Key Concepts

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

Fluid Volume Deficiency
Total Parenteral Nutrition (TPN) can lead to Fluid Volume Deficiency (FVD). TPN is a hypertonic solution, meaning it has a higher concentration of solutes compared to the fluids in our body's cells. This high concentration of solutes can draw water out of the body's tissues, causing them to dehydrate.

Here are some key points to understand about Fluid Volume Deficiency:
  • Causes: The hypertonic nature of TPN can lead to the movement of water out of cells.
  • Symptoms: Signs to watch for include dry mouth, decreased skin turgor, rapid heartbeat, and low blood pressure. Patients might also feel dizzy or weak.
  • Prevention and Monitoring: Nurses should closely monitor the patient's fluid balance through regular assessment of intake and output, and watch for any signs of dehydration.

Ensuring proper fluid balance is crucial when administering TPN to prevent complications such as FVD.
Hyperglycemia
Hyperglycemia, or high blood sugar, is another potential complication of Total Parenteral Nutrition (TPN). Since TPN solutions contain a high concentration of glucose, it's easy for a patient's blood sugar levels to rise unexpectedly.

Understanding Hyperglycemia in the context of TPN is important:
  • Causes: The glucose content in TPN is necessary for providing energy but can cause elevated blood sugar levels if not managed properly.
  • Symptoms: Symptoms include increased thirst, frequent urination, headache, and blurred vision. In severe cases, it can lead to diabetic ketoacidosis.
  • Prevention and Monitoring: Regular blood glucose monitoring is essential. Adjustments to the TPN formula or the use of insulin may be necessary to maintain glucose levels within a safe range.

Effective management of glucose levels is a key part of providing TPN.
Electrolyte Imbalance
Electrolyte Imbalance is another issue that nurses must monitor in patients receiving Total Parenteral Nutrition (TPN). Electrolytes, such as sodium, potassium, and magnesium, are essential for many bodily functions and must be kept in balance.

Here is a deeper look at Electrolyte Imbalance with TPN:
  • Causes: Imbalances can arise due to the high nutrient and electrolyte content in TPN solutions, which may not match the individual needs of every patient.
  • Symptoms: Depending on which electrolyte is out of balance, symptoms can vary widely. For example, low potassium (hypokalemia) can cause muscle weakness, cramps, and arrhythmias, while high sodium (hypernatremia) can lead to confusion and seizures.
  • Prevention and Monitoring: Frequent blood tests to monitor electrolyte levels are crucial. Based on these test results, the TPN formula may be adjusted to ensure that the patient's electrolytes remain within the normal range.

Nurses play a key role in monitoring and adjusting TPN to prevent and treat electrolyte imbalances.

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Most popular questions from this chapter

Using the Parkland formula ( \(4 \mathrm{ml}\) of lactated ringer's solution/\% TBSA burn/kg body weight/24 hours), the nurse would calculate fluid replacement for a \(70-\mathrm{kg}\) client with a \(50 \%\) TBSA burn over 24 hours as A. \(1400 \mathrm{ml}\) B. \(14,000 \mathrm{ml}\) C. \(6720 \mathrm{ml}\) D. \(700 \mathrm{ml}\)

What symptom reported in the health history of a underweight teenager indicates the need for careful assessment of nutritional status? A. Black, tarry stools B. Loose, frothy stool C. Flat, ribbon-shaped stool D. Mahogany colored, formed stool

The drug book states that a therapeutic dose for a medication is 50鈥�75 mg per kg of body weight per day. The child weighs 33 pounds and is to receive the med- ication 4 times a day. What would be the maximum amount of drug the child should receive per dose? Record your answer is a whole number carried out to two decimal places. _____ mg per dose Answer: 281.25 mg per dose; 33 pounds divided by 2.2 pounds per kilogram 15 (the child鈥檚 weight in kilograms); 15 times 75 1125 mg per day divided by 4 doses equals 281.25 mg.

When assessing deep tendon reflexes, when does the nurse use the wide end of the reflex hammer? Mark all that apply. The nurse uses the wide end of the reflex hammer to check A. brachioradialis reflex B. biceps reflex C. triceps reflex D. patellar reflex E. Achilles reflex \(\mathrm{F}\) cremasteric reflex

When the family notices that the Total Parenteral Nutrition the surgical client is receiving contains insulin, they question the nurse about why insulin has been added to the bag. The nurse explains that the client: A. is a diabetic and needs the exogenous insulin. B. is underweight and the insulin will help with weight gain. C. is a pseudodiabetic due to the sugar content of the solution. D. needs the insulin because of ileus secondary to the surgical procedure.
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