An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include:
a. Preparing the family for impending death.
b. Teaching the family signs of central venous catheter infection.
c. Teaching the family how to calculate caloric needs.
d. Securing TPN and gastrostomy tubing under diaper to lessen risk of dislodgment.
ANS: B
During TPN therapy, care must be taken to minimize the risk of complications related to the central venous access device, such as catheter infections, occlusions, or accidental removal. This is an important part of family teaching. The prognosis for patients with short bowel syndrome depends in part on the length of residual small intestine. It has improved with advances in TPN. Although parents need to be taught about nutritional needs, the caloric needs and prescribed TPN and rate are the responsibility of the health care team. The tubes should not be placed under the diapers because of risk of infection.
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