The nurse caring for a client receiving parenteral nutrition via a central venous catheter determines that the client's temperature is elevated, white blood cell count is elevated, and the client is lethargic. The nurse suspects the client is septic. Which actions by the nurse are appropriate in this situation?

Question

1. Replacing the parenteral nutrition with a normal saline solution
2. Changing the IV tubing
3. Saving the remaining TPN
4. Recording the lot number of the TPN
5. Notifying the health care provider.

Answer 1

2, 3, 4, 5
Rationale 1: The fluid should be replaced with a 5% or 10% dextrose solution, not normal saline, because the client has adjusted to a high sugar intake via the TPN, and eliminating all sugar infused could result in hypoglycemia.
Rationale 2: Changing the IV tubing is a correct action.
Rationale 3: Saving the remaining TPN is a correct action.
Rationale 4: Recording the lot number of the TPN is a correct action.
Rationale 5: Notifying the health care provider is a correct action.
Global Rationale: The fluid should be replaced with a 5% or 10% dextrose solution, not normal saline, because the client has adjusted to a high sugar intake via the TPN, and eliminating all sugar infused could result in hypoglycemia. Changing the tubing, saving the remaining TPN, recording the TPN lot number, and notifying the health care provider are correct actions.