Assessment of blood glucose levels is prescribed every 6 hours for a patient who is receiving total parenteral nutrition (TPN). The patient asks why this is necessary. Which of the following responses by the nurse is most appropriate?
a. "When people receive TPN, they develop mild diabetes, which needs to be well regulated."
b. "TPN contains a lot of sugar. We monitor blood glucose to be sure it doesn't get too high."
c. "There is a lot of sugar in the solution, which can increase the risk for rebound hypoglycemia."
d. "We have to monitor your glucose because the physician prescribed it."
ANS: B
Because of the high glucose concentration of TPN, the patient is at risk for infection and blood glucose disturbances. Ongoing assessments include blood glucose levels according to institution policy. Glucose should return to normal after TPN is discontinued, so the patient should not be told he has diabetes unless a diagnosis has been made. Rebound hypoglycemia can occur after TPN is discontinued. A physician may have prescribed the monitoring, but it is not a satisfactory answer for the patient.
You might also like to view...
The nurse is instructing a client with an anxiety disorder on behavioral tools to help with coping. Which tools to help with coping should the nurse include in the teaching session?
Select all that apply. A) Reading self-help literature B) Thought stopping C) Journaling D) Distraction E) Practicing yoga
Standards of nursing practice are developed within the profession to describe practice and establish the minimum level of safe practice. The purpose of standards of nursing practice can include:
a. helping to ensure that nurses are competent and safe to practice. b. serving as a guide for nurses providing care. c. determining whether the actions of nurses accused of malpractice are consistent with reasonable expectations. d. all of the above.
Nancy tells the school nurse that she is on a popcorn diet to loose weight. The nurse replies, telling her:
1. Restricting food choices is an excellent way to lose weight. 2. Popcorn diets work by filling the stomach without adding calories. 3. Weight loss is best accomplished by following a balanced diet with exercise. 4. Popcorn is a natural food containing all the nutrients needed for a balanced diet.
For which patient should the nurse consider an application of cold?
a. Menstrual cramping b. Infected wound c. Fractured ankle d. Degenerative joint disease