Prior to administering a hypertonic total parenteral nutrition solution, the nurse verifies that the client has:
1. serum electrolyte imbalances.
2. an insulin coverage scale.
3. robust peripheral veins.
4. a central venous access device.
Correct Answer: 4
Rationale 1: Electrolyte imbalances should be corrected prior to initiating therapy; however, the client does not have to have an electrolyte imbalance to receive TPN.
Rationale 2: It is not necessary to have orders for insulin coverage prior to initiating TPN; however, it is important to monitor glucose levels.
Rationale 3: Hypertonic solutions should not be administered peripherally.
Rationale 4: A central venous access device, with confirmed placement, is required to infuse a hypertonic TPN solution.
Global Rationale: A central venous access device, with confirmed placement, is required to infuse a hypertonic TPN solution. Electrolyte imbalances should be corrected prior to initiating therapy; however, the client does not have to have an electrolyte imbalance to receive TPN. It is not necessary to have orders for insulin coverage prior to initiating TPN; however, it is important to monitor glucose levels. Hypertonic solutions should not be administered peripherally.
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