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Ch 14 Nutritional Support Questions &Exam (elaborations) answers 100% satisfaction guarantee
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STUVIA 2024/2025Ch 14: Nutritional Support
ANS: A
Patients receiving TPN are at risk for air embolism and will report chest pain and be dyspneic with
coughing and cyanosis. Patients with pneumonia will have cough and either adventitious breath
sounds or diminished breath sounds. Patients with pneumothorax will have unilateral absent breath
sounds and respiratory distress. Patients with pulmonary edema will have crackles and dyspnea. -
✔✔The nurse is caring for a patient who is being treated with total parenteral nutrition (TPN). The
patient is experiencing chest pain, and the nurse observes shortness of breath and coughing along
with cyanosis. The nurse understands that this patient is most likely experiencing which condition?
a. Air embolism
b. Pneumonia
c. Pneumothorax
d. Pulmonary edema
ANS: A
Rationale: All enteral equipment should be labeled and changed every 24 hours. Since the tubing is
not labeled, the nurse should change and label it as soon as the current infusion is complete. The
%
infusion is set so that 240 mL will infuse over 45 minutes, which is appropriate, so the rate does not
need to be increased. The head of the bed should be at least 30 degrees, so there is no need to
lower the head of the bed. The nurse should check for residual just prior to administering the next
infusion, but it is not indicated at this point. - ✔✔The nurse assumes care of a patient who has been
receiving intermittent enteral feedings of 240 mL of a polymeric formula every 4 hours for the past 48
hours. The patient is in bed with the head of the bed elevated 60 degrees. The enteral tubing is intact,
and the enteral pump is infusing at 320 mL per hour. The nurse notes 60 mL of solution left in the
bag. The tubing is not labeled. What will the nurse do?
a. Change and label the enteral tubing when this infusion is complete.
b. Increase the infusion rate to 480 mL per hour to complete the infusion.
c. Lower the head of the bed to 30 degrees.
d. Stop the infusion and check for residual before resuming the infusion.
ANS: A
Rationale: The nurse should determine gastric residual before each feeding when patients are
receiving intermittent feedings. A residual greater than 100-150 mL may indicate the patient has an
obstruction and is not digesting the feeding. This patient has a residual of 50 mL, so the nurse may
proceed with the next feeding. If the residual was 100-150 mL, the feeding should be held for 1 hour
and the residual rechecked prior to administration. If it is still elevated on the second check the
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, STUVIA 2024/2025
provider should be contacted. The nurse cannot change the rate of an enteral infusion without an
order from the provider. - ✔✔The nurse is preparing to administer an enteral feeding to a patient who
receives 300 mL of a
polymeric formula over 30 minutes every 4 hours. The nurse checks the residual prior to
initiating the feeding and notes a residual amount of 50 mL of formula. Which action will the nurse
take next?
a. Administer the feeding as ordered.
b. Administer the feeding over 60 minutes.
c. Hold the feeding and notify the patient's provider.
d. Wait 1 hour and recheck the residual again.
ANS: A
The recommended energy intake is 25 to 35 kcal/kg/day; critically ill patients require 50% more than
the normal energy requirements (approximately 3000 calories per day). Patients should receive 30-35
to 60-55 kcal/kg/day and 1 to 2 g/kg/day of amino acids. For a 60-kg patient, the number of calories
should be 1800-2100 to 3600-3300 kcal/day, and amino acids should be 60 to 120 g/day. - ✔✔The
nurse is caring for an adult with severe burns who weighs 60 kg. Prior to initiating total parenteral
nutrition (TPN) therapy, the nurse reviews the orders. Which TPN order is correct for this patient?
a. 3000 kcal, 120 g amino acids per day
%
b. 2400 kcal, 50 g amino acids per day
c. 1500 kcal, 100 g amino acids per day
d. 3600 kcal, 150 g amino acids per day
ANS: A
Total parenteral nutrition (TPNN) carries a greater risk of sepsis than enteral nutrition. TPN can
provide sufficient calories, and there is no increased risk of aspiration with TPN. TPN does not
increase the risk of dehydration. - ✔✔The nurse is preparing to administer enteral nutrition to a
patient who has had a stroke and who cannot swallow. A family member asks why the patient is not
receiving intravenous nutrition. What information will the nurse provide to the family member?
a. Parenteral nutrition carries a higher risk of infection.
b. Parenteral nutrition does not provide sufficient calories.
c. Parenteral nutrition increases the risk of aspiration.
d. Parenteral nutrition is hyper-osmolar and increases the risk of dehydration.
ANS: A
TPN with IV therapy is prone to air embolism. Symptoms of air embolism are coughing and dyspnea.
Decreased breath sounds occur with aspiration, which is a complication of nasogastric feedings.
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